Governor strikes back; delegate’s concern remains unresolved

Gov. Lou Leon Guerrero said Congressman Michael San Nicolas should recognize her efforts the past five months to migrate about 6,000 Compacts of Free Association residents of Guam from the locally-funded health insurance program into federally-funded Medicaid. She chastised Mr. San Nicolas, in a response to his Tuesday letter calling her to enroll more COFA migrants into Medicaid, for spreading “misinformation” about her administration.

Mr. San Nicolas wrote Tuesday, “As of 2018, nearly 19,000 COFA migrants were accounted for as residents of Guam. Yet in 2020 there were only 6 [Medicaid] enrollees, in 2021 there were only 488, and as of this year there are only 1,311. This means that approximately 17,000 citizens do not have meaningful access to life-saving healthcare.”

The congressman reasoned that the failure to enroll migrants into any type of health insurance program – including either the locally-funded Medically Indigent Program (MIP) or Medicaid – “puts all our people at risk, but most especially our residents from the RMI, FSM, and Palau, their children, and their families.”

He asked that the governor reach out to these communities to enroll more migrants, especially those who did not previously have MIP coverage.

While San Nicolas’s premise is valid, the data he used to make his point was of claims paid, and not of total Medicaid enrollment.

“According to the Department of Public Health and Social Services (DPHSS), as of today, we have successfully moved approximately 6,400 COFA cases from MIP to Medicaid, resulting in tremendous savings to the government of Guam,” Ms. Leon Guerrero wrote to the congressman today.

The movement of 6,400 migrants from MIP to Medicaid indeed is a positive achievement, as the administration moved the cost of healthcare for those 6,400 residents from local coffers to federally-funded Medicaid.

But, San Nicolas’s concern is for the COFA migrants who did not have MIP to begin with, and had no health coverage whatsoever.

That was part of the reason for Congress’s December 2020 passage of legislation co-authored by San Nicolas allowing COFA migrants to be covered under Medicaid. Mr. San Nicolas wants those COFA migrants who have no coverage whatsoever (either from private insurance or MIP) to be signed up for Medicaid with haste.

Ms. Leon Guerrero defended her administration’s record on the matter, stating in her letter to San Nicolas: “From the start of our Administration, we have been unwavering in our belief that all Guam residents should have access to healthcare. Before legislation expanded Medicaid eligibility, we provided healthcare to our COFA brothers and sisters through the Guam Medically Indigent Program (MIP), a 100% locally-funded program.”

“We are working with non-profit organizations to conduct community outreach to underserved populations, to ensure that they receive valuable information regarding all services available to them, including Medicaid, SNAP, preventative care through our Community Health Centers, immunizations, and other support services,” the governor wrote. “We have translated information regarding these services into several languages, to ensure the greatest access possible to the whole of our community.

“Our team works hard every day to inform, process, and enroll those eligible for these programs and will continue to do so despite the limited resources currently available, and the lack of a permanent solution to our Medicaid inequity issues, which, as you know, can only be addressed in Congress. Spreading misinformation and false allegations regarding our Administration’s purported failure to enroll eligible members of our community in Medicaid, or in any other federal program the government of Guam administers, is irresponsible, divisive, and, frankly, disappointing. Our Administration has tirelessly advocated for amending Medicaid eligibility to include FAS citizens.”

You may read the governor’s full letter below:

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