Compact for Free Association Solutions through state, federal and COFA nation levels using a triple bottom line framework.
Presented by James Cadaoas and Elena Farden for Chaminade's MBA 741 Government Relations class.
9. Court Cases
Comprehensive Healthcare Reform (1996)
States are no longer required to provide healthcare to non-pregnant,
aged >19 years, lived in the states for <5 years (“new residents”)
States may still provide healthcare if they want to
Hawaii keeps Medicaid equivalent programs for new residents
Korab v Koller (2010)
Hawaii Adopts BHH program due to budget crisis
BHH provides less than Medicaid equivalent healthcare
Plaintiffs argue: BHH is discriminatory/based on national origin, in
violation of 14th amendment and ADA
Defense: Adhering to federal standards
10. Court Cases
Korab V Fink (April 2014)
“Congress has authorized states to do exactly what Hawai‘i has
done here—determine the eligibility for, and terms of, state benefits
for aliens in the narrow third category, with regard to whom
Congress expressly gave states limited discretion. Hawai‘i has no
constitutional obligation to fill the gap left by Congress’s withdrawal
of federal funding for COFA Residents.”
- California Circuit Court Judge, Margret McKeown
http://cdn.ca9.uscourts.gov/datastore/opinions/2014/04/01/11-15132.pdf
11. Court Cases
COFA residents eligible for Medicaid if*
18 or under
Pregnant female
Lawful resident living in the state for 5 years and meets income
requirements
Otherwise, BHH eligible
Discourages immigration specifically for medical treatment
Ethical?
* http://aspe.hhs.gov/hsp/11/ImmigrantAccess/Eligibility/ib.shtml#Medicaid
12. Introduction to the Solutions
No silver bullet solution
Complex problem with many different
variables
Required Government Action
State
Federal
COFA independant
Solutions will cost money in the
short run, but save in the log run
Overall goal: To achieve parity
between COFA and Hawaii
residents
13. Social Change & Education
State level solution
COFA residents have a strong cultural identity that doesn’t translate
well into western workplaces
More state-funded nonprofits focused on social integration
Turn the cultural diversity from disadvantage, into an advantage
Access to these programs may
require green-card registration
Focus on getting COFA
residents into the workforce
and contributing via taxes
21. Federal Incentives
Increased awareness is imperative
Hawaii’s residents can play a role
Goal of awareness is not for the awareness itself to solve the
problem, but for the new ideas generated to breathe life into the
situation
Increased funding, split between COFA nations and COFA affected
states
Creates incentive for COFA nations to take care of their citizens
Solves the funding gap in Hawaii and other states
Much easier to increase funding by $50 million, than by $3.6
billion