FAYETTEVILLE -- Arkansas should include its thousands of residents from the Marshall Islands and other Pacific islands in the state's ARKids First and other Medicaid programs, experts and advocates for the islanders said Wednesday.
Northwest Arkansas is home to about 12,000 Marshallese, Melisa Laelan, director of the Arkansas Coalition of Marshallese, told about 100 researchers and health care providers during the Gathering for Pacific Islander Health conference.
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The first-ever Gathering for Pacific Islander Health runs through this afternoon with sessions in Fayetteville’s Town Center and Chancellor Hotel. To see a schedule and find more information, go to www.pacifichealthga….
The Marshallese aren't typical immigrants, as a 1986 Compact of Free Association lets them travel and work in the United States without visas. But they're not citizens and don't qualify for Medicaid programs unless a state decides to include them. With high rates of diabetes, cancer and other diseases affecting Pacific Islanders across the country, state and federal assistance is needed for adults and children in poverty, Laelan and others said.
"Our best chance to move on this is to build momentum, educate our members of Congress and build those relationships," said Kathy Ko Chin, president of the Asian & Pacific Islander American Health Forum, a national advocacy organization. "It will take all of us and our allies all across the country."
The U.S. detonated dozens of nuclear weapons in the Marshall Islands during tests more than half a century ago. The radiation and fallout, crowded conditions on some islands, relatively low incomes and other factors contributed to the decline of traditional fish and plant-based diets in favor of white rice, Spam and other processed foods, according to the nonpartisan Migration Policy Institute and reports from other research organizations.
Now almost all Pacific Islanders are overweight, and about half of those in Arkansas have diabetes, according to the University of Arkansas for Medical Sciences, which is hosting the three-day conference that ends this afternoon.
A little more than half of the Marshallese in Arkansas have health insurance, mostly through their jobs, according to a 2013 report from The Winthrop Rockefeller Foundation in Little Rock. Meanwhile, about 40 percent are in poverty, according to census data collected from 2007-11.
"We are seeing many family members paying more than they can afford, even with subsidies" provided under the Affordable Care Act, Laelan said.
Originally, migrants from the Marshall Islands, Palau and other islands who came to the U.S. under the 1986 compact could qualify for Medicaid if needed. Congressional reforms in 1996 removed that eligibility.
Advocates have been trying ever since to undo what many at the conference suspected was a simple oversight at the time. Republicans in Congress, generally opposed to the Affordable Care Act and growing health care spending, haven't passed the proposal out of committee, Ko Chin said.
That opposition extends to Arkansas as well.
"At some point we have to take care of U.S. citizens first," state Sen. Bart Hester, R-Cave Springs, said in an interview after the session. "I get it that they're coming here legally, and if they're coming here legally, I'm all for it. But you know, they are not U.S. citizens. We can't even afford to take care of U.S. citizens."
The push has had some success at the state level. Joe Enlet, a board member with the Compact of Free Assocation Alliance National Network, said Wednesday that Oregon's governor just signed a bill to provide Medicaid assistance after four years of discussions with state officials, nonprofits, labor unions and others.
"Let's do it the island way, the relational way," Enlet told the other attendees. "We literally talked to everybody."
Laelan said a similar bill could go to the Arkansas General Assembly during its regular session in 2017. At least one legislator is willing to sponsor it, Laelan told the group, though she declined to say who.
"At least we are moving a little," she said.
As for ARKids, Arkansas Advocates for Children and Families has been in talks with the governor's office to extend the Medicaid program to islanders and other migrant children who are lawfully living here, said Laura Kellams, the group's Northwest Arkansas director. About 2,000 children could be affected by the change, she said.
Arkansas must submit and get approval for a state-plan amendment from the federal Center for Medicare and Medicaid Services, according to a 2015 report on the issue in the American Journal of Public Health.
"All we have to do is check the box," Kellams said, and with the state's poverty rate, 100 percent of the program would be covered with federal dollars. "We think that it has a really good chance."
The governor's office didn't return a request for comment on the two programs Wednesday afternoon. But several Northwest Arkansas legislators are on board for at least the ARKids expansion, said State Sen. Jon Woods, R-Springdale. He added he wouldn't "have any issue" with the Medicaid inclusion for all Marshallese as well.
"The Marshallese community are documented and they're here legally, and we know who they are," Woods said, pointing to the negative impact of U.S. weapons tests in the Pacific. "A lot of people just don't understand the history, but once you explain it to them, they understand."
Metro on 05/26/2016