Gov appeals for time to implement Obamacare
Governor Lolo Matalasi Moliga is requesting of the Secretary of US Department of Health and Human Services Kathleen Sebelius additional time to prepare a strategy to participate, if viable, in another’s state’s insurance exchange under the Patient Protection and Affordable Care Act (ACA), also known as Obamacare.
The governor has also written to Hawai’i’s Governor Neil Abercrombie, noting that American Samoa is interested in joining the State of Hawaii’s health insurance marketplace — the Hawa’ii Health Connector. Both letters were sent last week.
Governor Lolo, who’ll be in Hawai’i next month, sought to meet with the Abercrombie to have a “serious dialogue” regarding Hawai’i’s Connector team, in order to explore the feasibility of American Samoa joining the Connector and providing financial support both from federal and local funds.
According to the governor’s letter to the USDHHS, given that his administration is new, they have not had the adequate resources to address the unclear and uncertain implications presented by the implementation of the Obamacare in the territory.
“Your previous efforts to obtain assessment information from our territory, I feel, have been inadequately addressed at the cost of losing this landmark opportunity to improve health insurance access to our people."
"In its initial response to your inquiry for an assessment about American Samoa's choice between Medicaid expansion and establishing an Exchange, the American Samoa Government in March 12, 2012, elected to apply its formula allocation towards Medicaid expansion.”
The governor said, however, “I have decided to revisit this decision because I feel that the brevity with which this decision was explained did not thoroughly consider the long term policies for healthcare sustainability.”
Lolo pointed out the government has experienced over many decades “the lack of access to health insurance coverage contributing to the healthcare system’s insolvency each year, and exacerbating the overall financial state of the territory which in turn impacts federal resources.
“We need to consider other options in providing access to affordable and quality healthcare for people in the territory," he told Sebelius.
The governor pointed out the passing of the ACA provides a landmark opportunity for American Samoa to finally achieve equitable access to health insurance coverage.
Unfortunately, the interpretation of the applicability and implementation of the ACA law to the US territories has more questions than answers, especially regarding American Samoa, says Governor Lolo.
Lolo further noted that currently American Samoa is unable to implement the Health Insurance Exchange or Exchange provisions of ACA because there are “no” third party health insurance providers that provide qualified health insurance plans for the people in spite of many efforts in the past to attract such providers.
He states the barriers to attracting insurance providers to American Samoa are: its remote location, alleged low volume of beneficiaries, high risk population and the high expense.
Lolo explained in his letter that under government subsidized health insurance coverage our eligible Medicaid/CHIP population is 87.7%; our dual eligible Medicare beneficiaries is 6.77%; and some beneficiaries of Medicaid and/or Medicare also have supplemental Tricare coverage.
“Our people, who are not covered under Medicaid or Medicare are simply left uninsured and that has always been the state of affairs,” he stated.
The governor then notes, “All this time, efforts have been focused on defining which provisions of ACA apply to the US territories, but there has been a basic oversight of the fundamental fact that at least in American Samoa, our people have no access to purchase qualified health insurance plans."
Lolo said given that Hawai’i is the closest state to American Samoa, with many families having close ties to the Aloha State, he is seeking to negotiate for American Samoa to join in the Hawaii Health Connector health insurance exchange.
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