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Bill to fund U.S. gov’t includes historic Medicaid permanence for territories

Congresswoman Uifa’atali Amata
… and a 6th straight funding increase for American Samoa
Source: Uifa’atali Amata’a Washington D.C. office press release

Washington, D.C. —  Congresswoman Uifa’atali Amata is reporting that elements of the 2022-2023 Appropriations legislation, unveiled Tuesday, notably includes a permanent federal matching rate of 83 percent for all Medicaid expenses for the four smaller territories, as well as a $1 million increase she requested for the ASG Operations budget. This $1.7 trillion Appropriations package is being voted on in both houses of Congress today after some final negotiations.

Congresswoman Amata is encouraged that the omnibus includes two major victories for the territory.

First, Congress would make permanent the Federal Medical Assistance Percentage (FMAP) increase for the four smaller territories from 55 percent to 83 percent – a bipartisan breakthrough originally in 2019 legislation but year-to-year at the time. The FMAP is the percentage of Medicaid healthcare services that the federal government will pay. As such, the federal government will continue to pay 83 percent by federal statute of all Medicaid expenses in the territory, provided that ASG pays the remainder. As this is the best non-emergency rate in the nation, this permanent rate would allow the American Samoa Government to focus resources to other areas of healthcare, while also allowing potential healthcare providers new stability in starting, planning, and maintaining their businesses.

The bill’s section summary includes the following: Section 5101 extends Puerto Rico’s higher federal Medicaid match of 76 percent through fiscal year 2027 and permanently extends a higher federal Medicaid match of 83 percent for American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and the U.S. Virgin Islands. In addition, this section establishes a new framework for Puerto Rico’s Medicaid enhanced allotments for the next five fiscal years. The section also makes programmatic improvements to the territories’ Medicaid programs, including requiring increased provider payment rates and improving contracting practices for Puerto Rico and providing funding for data system improvements for American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and the U.S. Virgin Islands.

Second, the omnibus also includes an increase of $1 million to the ASG operations account at the Department of the Interior, $3 million more than the Biden administration’s request. The ASG operations account funds critical ASG services like the judiciary. This increase marks the sixth consecutive increase of the account at the request of Congresswoman Amata, after years of previous level funding.

 “The omnibus is a series of bills that broadly includes the federal budget for 2023, and I am happy that the permanent extension of our FMAP to 83 percent made the cut, and what that would mean long term for our Territory,” said Aumua Amata. “If enacted, this change will give our system stability that we have always lacked.”

She continued, “I am also thankful for the response to my request for an increase to the operations account, as it totals over $5.3 million over the six years of increases. With this increase and the permanent improvement to the FMAP, American Samoa would have the opportunity to invest our resources in the priorities that we have set – building a new hospital, strengthening our economy, and securing a better future. I stand ready to work with the Governor, Lt. Governor, and the entire government to make the most of these opportunities.”

 “As we await the votes, I want to thank the leadership of the Appropriations committees of both houses of Congress, Sens. Patrick Leahy and Richard Shelby, and Reps. Rosa DeLauro and Kay Granger, for their hard work crafting these appropriations bills,” she concluded. “It is a bittersweet moment for me, as Senator Shelby, a dear friend, will be departing Congress after 36 years in the Senate and 8 years in the House. I also thank House Natural Resources Committee Chairman Raul Grijalva and Ranking Member Westerman, along with Chairman Frank Pallone and Ranking Member Cathy McMorris-Rodgers of the House Energy and Commerce Committee that have been so helpful to American Samoa in the areas of federal funding and Medicaid FMAP expansion. Finally, I thank my territorial colleagues, particularly Rep. Stacey Plaskett of the US Virgin Islands and Rep. Kilili Sablan of the Northern Marianas, for their never-ending partnership in the fight to improve federal services for all the territories.”