‘CNMI would take a hit if…’

President-elect Donald Trump has openly expressed his desire to repeal President Barack Obama’s signature healthcare program, the Affordable Care Act, usually disparaged by Republicans as Obamacare. However, Helen Sablan, the CNMI director for the State Medicaid Agency, said the Commonwealth would be taking a hit if that happens.

Sablan did state that it is still too early to speculate if it will actually happen but if repealed, the lack of ACA would deny many residents access to proper healthcare benefits due to the loss of funds.

“It’s going to be a major impact because covering more people, getting additional funds, and then helping more people with existing health issues are going to be taken away,” said Sablan.

Commonly called the Affordable Care Act, the program is officially called the Patient Protection and Affordable Care Act. According to online sources, it was intended to increase health insurance, lower the uninsured rate, and reduce the costs of healthcare.

Thanks to ACA, the CNMI has received funding amounting to $100 million from July 1, 2011, right up to Sept. 30, 2019. ACA has been constantly applied for since the last fiscal year. Statistics for fiscal year 2015-2016 was not readily available due to technical difficulties at the time of the interview, but for fiscal year 2014-2015 alone, the CNMI Medicaid Office approved 14,053 applicants, 12 for the Northern Islands, 777 for Rota, 13,521 for Saipan, and 775 for Tinian—and many of them receive treatment thanks to ACA funding.

“We open up to the people that are U.S. citizens or residents that…meet our income and resource [requirements] using Supplementary Security Income criteria since we are an SSI state,” said Sablan.

The SSI is a U.S. government program that provides allowances to people of low incomes that are aged 65 or older, blind, or disabled.

Under ACA, the Children’s Health Insurance Program and Medicaid were made to cover children to young adults up to age 26.

“There are just so many things that are under Obamacare that really helped us,” said Sablan.

“It’s premature to say now because of we don’t know what President-elect Trump is going to do, whether revamping the whole thing [or just parts of it]. We just have to wait and see,” she added.

Commonwealth Healthcare Corp. CEO Esther Muna shares the same view, thinking that it is still too early in the Trump presidency to speculate whether ACA would be repealed or even amended.

“At this time, we really have more questions than answers right now, so I join other health leaders in the 50 states and five territories in monitoring the movement of how the changes, if any, would affect our health system,” said Muna.

If ACA were to be repealed, Muna hopes that the new President would consider the possible impacts on U.S. territories.

“We are hopeful that the new administration will recognize the disparity in Medicaid funds for the CNMI and the territories and ensure funds will be available for eligible indigent care,” said Muna.

According to Muna, ACA was able to provide funding to supply the lone hospital service provider through reimbursements made by CNMI Medicaid.

“ACA has provisions that provide additional funding to Medicaid that ensures the Commonwealth Health Center gets reimbursed $1 million of its monthly cost while ensuring services are paid to the private providers and the off-island providers. The CNMI, like other territories, receive capped Medicaid funding. This additional funding beyond the cap has helped CHC in its operations and in improving hospital services,” clarified Muna.

“Also, over the years, ACA opened new funding opportunities to CHCC, such as expansion of services at our sole community health center in Kagman and innovative models to provide affordable and quality health care. We are hopeful that the grant funding received for these initiatives will not end despite having some linkage to the ACA,” added Muna, referring to Kagman Community Health Center’s benefits received by ACA.

Muna said CHCC would be on the alert for the possibility of the amendment or abolition of ACA.

“We will continue to monitor the movement of the existing policies and regulations that affect CHCC and the CNMI,” she said.