Palau paradise
As if there weren't already enough
angles, arguments, and standpoints on the health insurance debate, Hawaii now
brings us a curious new loophole involving citizens from islands you've never
heard of.
If you're one of the 48 million Americans
without health insurance, you will scratch your head ... and consider buying a
plane ticket. And if you're angry over the billions of taxpayer dollars Uncle
Sam may spend on a "public option," this will only fuel your outrage.
Since 1986, three small Pacific island nations—Palau,
the Marshall Islands, and the Federated States of Micronesia—have been in a
unique transnational agreement with the U.S. that has resulted in the
government spending millions on healthcare for non-U.S. citizen migrants.
The agreement between the U.S. and the
island states is known as the Compact of Free Association, which was initially
enacted as an economic, security, and restitutionary measure to repay the islanders
for the nuclear testing and storage that took place there since the 1940s.
Simply stated, COFA allows for citizens of the three nations
to live and work as legal migrants in the U.S. without having to go through the
typical arduous process to attain legal migrant status. But COFA doesn't addresses
the key issue of healthcare... something the government ignored or overlooked
when setting up the agreement.
And here's where the problems arise.
Because of its close proximity to the three COFA nations, Hawaii is a popular
migratory destination for COFA nation citizens, and the state now spends over
$100 million annually in services on them, the largest portion of which goes to
education and health benefits.
Sounds like a nagging COFA
While COFA states that jurisdictions whom
accept COFA migrants should not experience any adverse consequences, the
federal government only reimburses Hawaii $11 million annually. This results in an $89 million deficit
that must be shouldered by residents of our 50th state.
In the past few months, after years of
paying for health benefits for its legal non-citizen COFA residents, Hawaii decided
to get its house in order. The state passed a Health Reform plan that would
remove many of the COFA migrants from state health coverage. Although rumors of
taking patients off of critical dialysis and chemotherapy treatments have
turned out to be false, many COFA migrant residents will fall outside the scope
of any government-run healthcare—they will be ineligible for state healthcare
and have been ineligible for federal Medicaid benefits since 1996.
Interestingly, the federal government has
since stepped in and offered to pay millions of dollars to Hawaii over the next
two years, in order that Hawaii may continue funding COFA residents'
healthcare.
So to recap: If you are a U.S. citizen
without health insurance, what is the best way to receive it? Answer: Renounce
your citizenship, move to Palau, then move back to Hawaii as a non-citizen
migrant, and the government will hook you up. Sounds easy enough, no?