‘Equal healthcare treatment for territories’

Healthcare remains a hot button issue in Congress, despite the GOP-planned repeal and replacement bill for the Patient Protection and Affordable Care Act, or Obamacare, failing to reach the House floor for a vote.

House Speaker Paul Ryan (R-1st Wisconsin) yanked the bill from the calendar, expecting they don’t have the numbers. At least 31 GOP lawmakers were either against it or were leaning to vote no for its passage.

However, the story remains the same for territories like the CNMI. Being left out again in the Republican’s healthcare reform bill, just like what happened under Obamacare, where insular areas’ more than 4 million people, who are either U.S. citizens or nationals, were excluded.

This is what CNMI’s leaders like Gov. Ralph DLG Torres and Delegate Gregorio Kilili C. Sablan (D-MP) have been asking top officials in Washington D.C.: To include all five insular areas in healthcare reform.

Torres said the concerns are not new to Congress, citing a recommendation made by the Bipartisan Congressional Task Force on Economic Growth in Puerto Rico in a 2016 report.

The task force’s recommendation to strengthen the territories’ healthcare system was not only intended to improve patient outcomes. It would also enhance federal oversight, reduce the incentive for migration from the territories to the states, associate financial costs to state and federal governments, and stabilize and strengthen the fiscal condition of territory governments.

Torres said he agrees with the report’s recommendations as it is also related to Medicaid in the territories.

“I also respectfully ask that a repeal to any [ACA] provisions be followed by a replacement that would ensure continued provision of benefits currently budgeted by the CNMI government using the additional allotment provided under Section 1204 of the Act,” said Torres.

“A repeal without replacing this critical component will destabilize the existing program’s finances and limit available services to our population.”

He is also hopeful congressional leaders would remember that Obamacare changed a lot of aspects in the U.S. healthcare system rather than just the private health insurance industry, “including Medicare, Medicaid, healthcare administrative rules for simplification, preventive health initiatives, quality improvement initiatives, among many other impacts which merit careful consideration.”

Include insular areas

Sablan echoed the same sentiments. President Donald Trump had repeatedly stated during last year’s campaign that the GOP’s goal is affordable healthcare insurance for all.

Trump told his supporters in rallies before the November election that repealing and replacing Obamacare will be his administration’s first order of business.

Although he said he agrees with Trump’s goal, Sablan said there are certain provisions in the GOP reform and repeal bill that needs rewriting.

“The bill that House Republicans drafted would have taken away insurance from 24 million Americans—and had no help at all for the people of the Northern Marianas Islands.”

He added that he and other House Democrats raised their opposition to the bill, which was pulled from the House floor on Friday and was later declared dead. “I made my case during the debate on the floor against the bill and proposed instead that we work toward health insurance for all [U.S. citizens].”

“Our letter to Speaker [Ryan] and Democratic leader Nancy Pelosi (California 12th) asked for full inclusion in the Medicaid program, which cares for those with low incomes and already serves 14,000 in the [CNMI], including 10,000 children.”

Obamacare’s repeal and replacement have been at the center stage the past few weeks. The bipartisan territorial caucus had asked for the insular areas’ inclusion for their respective constituents and equality with U.S. citizens in the mainland.

“We also want tax credits to help middle income families buy insurance, which all Americans were offered in the repeal and replace bill, H.R. 1628. But we want those credits paid by the federal government, not an unfunded, federal mandate that insular governments have to pay, as Republicans proposed.”