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Dear Editor,

On Sunday morning, October 01, 2017, some key sources from the mainstream media in the nation reported that Congress just allowed the Children's Health Insurance Program (CHIP), which provides low-cost health insurance to 9 million children, to expire. The story went on to say that if action is not taken soon to restore the funding, the effects will become obvious in schools across the country, with many of the children in the program unable to see a doctor for routine checkups, immunizations, visits when sick, and other services.

The CHIP program was created under a law that was passed in 1997, with bipartisan support during the administration of Bill Clinton.

The Territory should be cautious of the current Republican-controlled Congress and its concerted effort with president Donald Trump and their party ideology in healthcare. The report went on to say that amid unsuccessful efforts to repeal and replace the Affordable Care Act (or Obamacare), the Republican-led Congress allowed the CHIP deadline to pass without restoring the funds.

The ASG Medicaid Office and our Congresswoman Amata have yet to break this stymie. But such a federal program for children's health, with about 1.7 million dollars of federal allotment and 0.7 million dollars of ASG allotment, that amounted to 2.4 million dollars of total spending in the FY 2015, revealed a significant role CHIP has on the healthcare of the territory provided at the LBJ hospital. (To determine the portion of care match at the CHIP matching rate, American Samoa calculates the claiming percentage for children under the age 19 with income between 100 and 200 percent Federal Poverty Level).

It is important to state that like Medicaid, CHIP program eligibility in American Samoa is not determined on an individual basis and individuals do not enroll in the CHIP, like all other territories and states. Instead, federal CHIP funds pay for care provided at the LBJ Medical Center. This is made possible from a federal mandate for American Samoa under section 19020) waiver of the Social Security Act. Again, like Medicaid, this same waiver has allowed the Secretary of DHHS to waive or modify any CHIP requirement except the statutory annual limit on basic federal CHIP funding.

The reason I'm compelled to write about the CHIP funds is that, I do have a personal attachment to CHIP, which is very dear to me.

In 1997, ASG via its state Medicaid Director, the late Mr. Niuatoa Andy Puletasi, was in the process of preparing the Territory's CHIP application; he was specifically interested with the School-Dental Program that was ongoing at the time. Mr. Puletasi was looking for a children's healthcare program in the territory to support ASG's CHIP application.

I told Mr. Puletasi that our School-Dental program was the only children's health program in the territory, whose annual target population was around 20,000 students performed on, on a daily basis. Mr. Puletasi was immediately convinced, and the rest is history.

The completed territory CHIP application was signed and submitted by then Governor, the late Tauese Sunia. The application was immediately approved by the Feds; and by early 1998, Federal CHIP monies was pouring in.

It was a very encouraging and rewarding experience for me. In prioritizing health care services, most of the CHIP funds went to medical, not dental. However, our School-Dental Program that began from scratch without a budget suddenly found itself with federal monies. But the greatest coincidence with our CHIP approval was that funds were readily available “at the right time” each year, accommodating the employment of the new local dentists graduating from Fiji School of Medicine from 1998 to 2002; the total number of dentists the territory produced consecutively within that period was ten (1 0).

I believe the CHIP funding is still a cornerstone for the health of our medical and dental patients at the LBJ Hospital, especially our children. The health of our children determines our future. If Congress has now allowed the federal CHIP funding to expire without action, then I'm sure that the acute treatment services, the essential medications, and professional staff development and retainment that have relied on CHIP for two decades will now be jeopardized.

The action of the Republican-controlled Congress to expire CHIP after having failed repeatedly to repeal the Affordable Care Act (or Obamacare) shows that sometimes political party ideology comes first before people and country; when that happens, then it is important for each politician in Congress to assess his or her own personal conscience and moral values.

Terminating CHIP is wrong and immoral.

Let's hope the Republican-led Congress restores CHIP.

Tuiasina Dr. Salamo Laumoli

Retired Chief of Dentistry LBJ Hospital, and former DOH Director