Samoan hospital debacle raises concerns of other insular areas

WASHINGTON, D.C.—As ranking member of the Subcommittee on Indian, Insular, and Alaska Native Affairs, Delegate Gregorio Kilili C. Sablan expanded yesterday a hearing on American Samoa’s hospital to include concerns about healthcare in all the U.S. insular areas.

Sablan visited the hospital in February as part of congressional delegation led by House Natural Resources Committee chair Rep. Rob Bishop (R-Utah).

“We got a first-hand look at the hospital—the deterioration of the physical plant, the lack of equipment and supplies, the difficulty of hiring and training staff,” Sablan said. “I look forward to hearing how we can make sure the people of American Samoa get the health care that all Americans have a right to.

“But American Samoa is not the only insular area struggling with healthcare.”

Sablan pointed out that as recently as last December, San Luis Hospital in the Virgin Islands was under threat of decertification by the Centers for Medicare and Medicaid Services for failure to meet basic federal standards.

“In my own district, the Marianas, our only hospital also faced decertification in 2012. A team from the Public Health Service came to the rescue and helped keep the hospital open.”

The decertification crisis in the Marianas occurred after the Commonwealth government cut off funding and established an independent hospital corporation that was supposed to be financially self-sufficient.

“The [Commonwealth Healthcare Corp.] has struggled to meet the costs of delivering healthcare services to the people of the Marianas,” Sablan said. “Half are below the federal poverty line and one-third have no health insurance. So, patients are often unable to pay for care.”

Making up the difference has been funding from Obamacare.

Sablan noted that Obamacare provided an additional $109 million in Medicaid funding for the Marianas. About $66 million of those funds had been drawn down by the end of last year.

By contrast, American Samoa has used only about $27 million of its Obamacare funding.

Subcommittee member Rep. Jennifer González-Colón (R-Puerto Rico) expressed concern about $150 million in Obamacare funding that American Samoa still has at its disposal, while the hospital facility and services have been allowed to deteriorate. Puerto Rico, by contrast, has been able to use up all of its Obamacare money.

The hearing came on the same day that the U.S. Senate was debating a complete repeal of Obamacare, which could take away all the extra Medicaid funding from all insular areas, and could provide some replacement.

Any replacement, Sablan said, should make the Medicaid program available to the insular areas in exactly the same way it is available to the rest of America.

“Beyond that, the federally-funded tax credits that are being proposed—that will help individuals and families by private insurance—must be available to Americans in American Samoa, Guam, the Marianas, and the Virgin Islands.

“The President promised ‘insurance for all,’” quoted Sablan. “We are all waiting.” (PR)