AAPCHO Advocates for the Restoration of COFA Migrant Eligibility in Federal Programs

April 29, 2014
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[Archive] Stacy Lavilla
Director of Communications
(510) 272-9536 x110

OAKLAND, April 29, 2014 –The Association of Asian Pacific Community Health Organizations (AAPCHO) urges Congress to restore Compacts of Free Association (COFA) migrants’ eligibility to federally supported health programs.

Under the U.S. Court of Appeals for the Ninth Circuit’s ruling earlier this month, Hawaii is not required to provide full Medicaid coverage to COFA migrants from the Republic of Palau, the Republic of the Marshall Islands and the Federated States of Micronesia.

AAPCHO believes keeping COFA migrants ineligible for federally supported health programs, like Medicaid, will be detrimental to this population’s health, and will significantly affect the health care providers that serve them.

“Because of current regulations, many COFA migrants are not receiving critical health care services, such as cancer treatment,” said Jeffrey Caballero, executive director of AAPCHO, adding, “If these regulations are maintained we expect many individuals to delay seeking care or forgo health care services altogether.”

“Health care providers serving this population, such as community health centers that serve all individuals regardless of insurance status or ability to pay, will continue to be under financial strain, as they will be shouldering the cost of providing services to COFA migrants without reimbursement from Medicaid,” he said.

COFA migrants comprise almost one-third of the overall patient population for some AAPCHO member community health centers in Hawaii.

COFA migrants were eligible for Medicaid until 1996, when changes to federal law rendered them ineligible. As a result, states with large COFA migrant populations have come under increasing pressure to address this issue. Without the support of federal funds, states and health care providers like community health centers have shouldered the responsibility of providing care to this population.

COFA migrants have a special status under U.S. law and are allowed to freely travel, reside and work in the U.S. as tax paying residents. There are currently over 56,000 COFA migrants residing in the U.S., many of whom experience heath disparities and inequities as a result of socioeconomic factors in their home countries and the U.S.’ military activities in these jurisdictions. Despite working and paying taxes in the country, COFA migrants are excluded from federally supported health programs.

AAPCHO is a national association of 34 community health organizations dedicated to promoting advocacy, collaboration, and leadership that improves the health status and access of Asian Americans, Native Hawaiian, and other Pacific Islanders in the U.S. For more information on AAPCHO and its Guiding Principles and Values, please visit


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Beverly Quintana
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