After a request made by Governor Lolo M. Moliga to Cindy Mann, Deputy Administrator of CMS/Director of Medicaid and CHIP, she has given her support and verbal approval to allow the American Samoa Medicaid State Agency to develop a universal health care coverage plan under the Medicaid program.

Medicaid Director Sandra King Young delivered the request on behalf of the Governor in a meeting with the Deputy Administrator of CMS on November 5, 2014.

She explained, “Governor Lolo had pursued and exhausted numerous options for health insurance and off-island coverage since he came into his administration. He began with requesting to join the Hawai’i Health Connector, negotiating provider agreements directly with Hawai’i hospitals and trying to attract third party health insurance providers, all to no avail.

According to Young, “Due to American Samoa’s past history of poor payments to hospital providers and vendors off island, providers do not want to sign provider agreements without ASG putting up at least $10 million in an escrow account to prepay for off-island referrals.

“Due to low volume, remoteness, inadequate local medical facilities, transportation and a high-risk population, health insurance providers are not interested and determine that it’s not cost effective for them to provide health insurance coverage for the residents of American Samoa,” she said, adding that “in spite of all the government’s efforts, American Samoans remain an uninsured population desperately lacking access to quality health care services as mandated under the Affordable Care Act (‘ACA’).”

The local Medicaid Director said, “Governor Lolo made the decision to propose a federal solution in partnership with our local government.”

Young noted, “This preliminary approval from CMS will allow our government to pursue changes to the Medicaid program to basically provide coverage for all our legal residents. The Medicaid office is currently drafting new language to the Medicaid State Plan to submit for official approval to CMS.”

The Medicaid Director anticipates that this process will take at least 12 to 18 months to review and receive official approval. In the meantime, there is much work that must be done to align local laws in order for the Medicaid office to implement universal health care coverage for legal residents.

She said, “In order for this universal coverage to go into effect, local laws must be amended to allow for the financial contributions to the Medicaid insurance plan to help sustain the plan especially to fund the matching requirements for off-island health care coverage.

“Details of how this plan will work continue to be in development. Some of the components that are critical to the realization of this universal health care coverage through the Medicaid program include the requirement of a sustainable source of local matching funds, individual enrollment of beneficiaries and access to off-island care,” she stated.

The Governor continues to pursue options with the State of Hawaii to re-establish access to Hawaii hospital providers for medically necessary care not available on island, Young explained, adding that “he intends to visit with the new Governor of Hawai’i in the New Year, leading up to the National Governor’s Association Winter Meeting to discuss a Medicaid partnership with Hawaii’s Medicaid program.

Gov. Lolo said, “This is a monumental first step to help our people receive the quality care they deserve. But the time has come for our people and our government leaders to understand that we must start paying into the health care system if we are to have the access that we want. Nothing is free in this world anymore. If we don’t help pay for the health care we need, then we will continue to have no access for off-island care and we will continue to struggle with trying to improve our local hospital and community clinics.”

(Source: ASG media release)