Washington, D.C. — U.S. Congressman Gregorio Kilili Camacho Sablan introduced legislation in the U.S. House of Representatives Tuesday to repeal the cap on federal Medicaid funding for the U.S. insular areas. Unlike the states, which have unlimited federal funding,

American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands each has an upper limit on annual funding set by law. The result is healthcare rationing for the over 4 million Americans living in these insular areas and a system that forces local officials to make life and death decisions based on money.

The coronavirus pandemic is exposing the gaps in our national healthcare system like never before,” Congressman Sablan said in his introductory remarks.

“One of those gaps is that our national Medicaid program does not reach all Americans with full coverage.”

Getting the same treatment as states under the Medicaid program has long been a goal of territorial congressional representatives. And the coronavirus crisis has already led to breakthroughs.

The Families First Coronavirus Response Act, passed in March, created equity between the states and the territories with respect to the federal-local match for Medicaid. Families First, also, provided additional federal dollars for the territorial Medicaid programs, but did not lift the cap.

“No matter how many fall ill, no matter how costly or prolonged their treatment, that cap will always limit care in the territories,” Sablan said.

“Now, as never before, we have to understand that, while some areas of our nation are ill, no area of our nation can be well,” he added.

Sablan was joined in introducing the bill by Committee Chairs Raúl Grijalva, D-Arizona, and Nydia Velázquez, D-New York. Delegates Michael San Nicolas, D-Guam, Aumua Amata Coleman Radewagen, R-American Samoa, and Stacey Plaskett, D-U.S. Virgin Islands, are also original co-sponsors, as are Reps. Chuy García, D-Illinois, Adriano Espaillat, D-New York, and José Serrano, D-New York. The bill is H.R. 6495.

As early as 2000, insular representatives have introduced legislation to get equal treatment with states under the Medicaid program. When Sablan was first elected in 2009 the federal-local match was 50-50 and Mariana annual funding was capped at $4.98 million. Twelve years later the federal-local match is 89-11, as good as any state. And Congress has appropriated $63.1 million, as the federal share for fiscal year 2020, a thirteen-fold increase in total funding. One-third of the people in the Marianas rely on Medicaid for their healthcare.