In 2010, as a cost-saving measure, the state intended to cut Med-QUEST for Hawaiʻi residents living here under the Compacts of Free Association (COFA). These members of our community, who come from three different countries in Micronesia, face many challenges in the United States, including widespread discrimination.

The Republic of the Marshall Islands, the Republic of Palau, and the Federated States of Micronesia have special relationships with the United States, which are defined under the different COFA agreements between the U.S. and each of the three sovereign states.

The U.S. and COFA states have reciprocal economic and military agreements that allow citizens of COFA states to live and work in the United States. Hawai‘i is home to many individuals and families from these nations who work, attend school, and contribute to the strength and diversity of our island community.

Beginning in 1997, the state had covered eligible COFA residents through Med-QUEST programs. In response to reduced revenues after the Great Recession, the State of Hawaiʻi decided, in 2010, to save money by ending Med-QUEST coverage and creating a markedly inferior plan, Basic Health Hawaiʻi (BHH).

Under this newly proposed plan, annual coverage would have been limited to just 10 days of inpatient hospital care, 12 outpatient visits, and a maximum of four prescription medications per month. This level of coverage is inadequate for the typical Medicaid patient, let alone one with severe chronic illness.

Even worse, BHH’s meager coverage would have cut off life-saving treatments such as chemotherapy and dialysis, making this cost-cutting measure a life-threatening one for Micronesian kūpuna and people with disabilities. These residents have no access to comparable healthcare in their countries of citizenship and no means to afford expensive medical treatment.