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UPDATE: US House passes extension of 100% Medicaid funding

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Now in the US Senate

Pago Pago, AMERICAN SAMOA — The House of Representatives has passed the extension of Medicaid assistance as part of a continuing resolution to fund the federal government beyond the end of the fiscal year, Sept. 30, 2019. It is now going to the Senate.

According to Congresswoman Aumua Amata, in a press release, “The Continuing Appropriations Act, 2020, and Health Extenders Act of 2019, H.R. 4378, specifies that the Medicaid assistance for the Territory, which passed earlier this year in disaster relief legislation, should continue an additional eight weeks, allowing work to continue for long term assistance.”

The current 100-percent assistance has freed up millions of dollars in funding that otherwise would have been used as the Territory’s 45-percent standard Medicaid share.

“This bill will provide another eight weeks 100-percent Medicaid funding,” said Aumua Amata. “Without this action, the special Medicaid assistance passed because of Storm Gita would have stopped at the end of September. I will continue working for long term Medicaid changes for the Territories that could be a significant improvement over the former 45-percent match requirement for the Territory.”

Long term Medicaid relief is already underway in Congress. In July, the House Energy and Commerce Committee passed major Medicaid assistance for the territories, a six-year plan including two years full federal match gradually descending to 76-percent, according to Amata.

In a media release, the American Samoa Office of the Governor and the Medicaid agency said they “applaud the passage of the Continuing Resolution passed by Congress, Sept. 18 that contained the extender of the 100% FMAP for the territories.”

 Local Medicaid Director Sandra King Young states, “Although the ACA funding will still expire on Sept. 30, 2019, the CR extension of the 100% FMAP will be a huge help for our territory through November 21.

“We will also still have the $16 million from the marketplace funding for the first quarter of FY2020.

“I am also hopeful that this CR success is a real indication of where we are going in terms of a permanent fix for the territories. But we will continue to work closely with the committees of jurisdiction and our territorial delegation to secure a permanent solution to the cap and FMAP,” King Young noted.

She said, “Governor Lolo is monitoring this very closely and working together with the territorial Governors to present a united message on the territories’ Medicaid programs. The Governor lobbied strongly this week alone to ensure that the territories FMAP provision remained in the CR.” 

Congresswoman Amata, in her press release notes that she participated in bipartisan development of major Medicaid assistance for the territories, and was an original co-sponsor of the Territories Health Care Improvement Act, H.R. 3631. That bill became part of a larger bill that she also cosponsored: H.R. 2328, The Community Health Investment, Modernization, and Excellence Act.

She said, “I appreciate the willingness to listen to our needs from all the leaders on this effort, and I’d like to thank Speaker Nancy Pelosi, Leader Kevin McCarthy, Energy and Commerce Chairman Frank Pallone and Ranking Member Greg Walden for their ongoing work.”

Amata concluded, “I’m excited to work with them to take this opportunity to strengthen our Territory’s health care and finances with a bill improving Medicaid policy for the territories.”

Local Medicaid Director King Young pointed out that “since 2014, the Office of Gov. Lolo Matalasi Moliga through the Medicaid agency has advocated consistently before the U.S. Department of Health and Human Services (CMS) and the U.S. Congress, to educate federal policy makers on the territories’ Medicaid programs.

“The Governor's advocacy before the National Governors' Association and Medicaid agency’s resilience and perseverance in engaging key policy makers have resulted in increased awareness of the territories’ unfair underfunding status with the cap and FMAP match,” she said.

King Young said she has served for the past 6 years as the Territories Medicaid Board Representative on the Board of the National Association of Medicaid Directors (NAMD), the main lobbying and policy arm on Medicaid issues for Medicaid Directors; and the NAMD Director and staff often accompany her when lobbying before Congressional committees and offices.

She said “American Samoa's leadership has been a key factor in raising awareness at the federal level of the territories Medicaid issues.” 


The text of the CR for the territories is as follows:


Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, This Act may be cited as the ‘‘Continuing Appropriations Act, 2020, and Health Extenders Act of 2019’’.

 SEC. 1302. TEMPORARY INCREASE IN FEDERAL MEDICAL ASSISTANCE PERCENTAGE FOR TERRITORIES UNDER MEDICAID PROGRAM. Section 1905 of the Social Security Act (42 U.S.C. 5 1396d) is amended (1) in subsection (b), by striking ‘‘and (aa)’’ and inserting ‘‘(aa), and (ff)’’; and  (2) by adding at the end the following new subsection: ‘‘(ff) TEMPORARY INCREASE IN FMAP FOR TERRITORIES.—Notwithstanding subsection (b) or (z)(2), the  Federal medical assistance percentage for Puerto Rico, the  Virgin Islands, Guam, the Northern Mariana Islands, and  American Samoa shall be equal to 100 percent for the period beginning October 1, 2019, and ending November 21, 2019.’’