Northwest Arkansas' Pacific Islanders would lose access to government assistance for health coverage under a Senate Republican bill revealed Thursday, an immigration attorney said.
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A single paragraph in the 142-page proposal would bar the region's Marshallese and some other islanders from the individual insurance marketplace, said Matthew Lopas, health policy attorney for the National Immigration Law Center. The marketplace provides subsidies for low-income customers and lets them compare coverage options.
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To read the discussion draft of the Senate’s health care bill, go to http://bit.ly/2sFIk…">http://bit.ly/2sFIk…
The change affected Marshallese people is on page 2.
Source: U.S. Senate
Northwest Arkansas is home to around 12,000 Marshallese, according to the University of Arkansas for Medical Sciences. Many in the group rely on the marketplace because they don't qualify for Medicaid or Medicare and often earn relatively low wages.
Melisa Laelan, founder of the Arkansas Coalition of Marshallese, said the group this year helped more than 1,000 islanders sign up for marketplace coverage on top of hundreds more in previous years.
"Now all of a sudden it's been jeopardized," she said Friday. "It's frustrating, and I guess the best thing we can do is look for avenues [for coverage]."
Residents of the Marshall Islands and two other Pacific nations can travel, work and live in the United States without visas under a 1986 treaty giving the U.S. continued military access to the islands' territory. Marshallese have grouped together in Hawaii, Arkansas and other states since then, often coming to take on work at Tyson Foods and similar companies in Springdale.
Dozens of U.S. nuclear tests, poverty and other factors in the last several decades also have left many islanders with health problems such as cancer, high blood pressure and diabetes.
Tyson and other companies offer coverage for employees, but Laelan said many older Marshallese don't have jobs. She said a majority of the community is likely uninsured or insured through the marketplace. The medical university hasn't gathered survey data on the group's coverage, a spokeswoman said.
Roughly one-third of the islanders in the Fayetteville-Springdale-Rogers metropolitan area are in poverty, more than twice the rate for the region's overall population, according to the U.S. Census Bureau.
The insurance marketplace and its subsidies began under the Obama-era Patient Protection and Affordable Care Act, also called Obamacare. Many Marshallese have turned to the marketplace for the same reason the Senate proposal would keep them out of it: The Personal Responsibility and Work Opportunity Reconciliation Act of 1996.
The act, often referred to as welfare reform, limited public benefits to certain groups of immigrants and excluded the people covered by the 1986 treaty. It bars islanders from programs such as Medicaid, making private insurance the only option.
Pacific Islander advocates have long seen the exclusion as an oversight, and several states have chosen to extend public coverage to at least some of them. The Arkansas Legislature this year endorsed a plan to allow Pacific Islander children to access ARKids First, which provides medical and dental services to low-income children. The state next needs federal permission to make the change, which Northwest Arkansas officials hope could happen this year.
Obamacare extended the use of its marketplaces and subsidies to anyone "lawfully present" in the country, so the Marshallese were included. The plans have been an enormous help with needs such as dialysis, eye surgery and other care, several Marshallese have said.
"Most of their medications, they don't even pay for it," said Lucy Capelle, the coalition's director. She often accompanies Marshallese people during doctor visits to translate and paid some of their bills before they got coverage.
The Senate bill, however, switches the "lawfully present" phrase with a reference to the 1996 law, excluding the Marshallese once again. Laelan said she doesn't believe the ARKids plan will be affected.
It's not clear why the bill makes the change. Arkansas Sens. Tom Cotton and John Boozman, both Republicans, declined to comment on any part of the bill Friday, saying they were still reviewing it. Senate Majority Leader Mitch McConnell, the bill's primary architect, made no mention of the change in a Senate speech on the bill. It has also gone largely unnoticed in national media.
Lopas, the national immigration center attorney, said Thursday the Senate bill went further than the House-passed version by excluding the Marshallese from the marketplace completely, not just the subsidies. Immigrants in the middle of the asylum process or survivors of human trafficking could also be affected, he said.
Several Springdale legislators said they hadn't looked deeply at the bill and couldn't give much comment, but State Sen. Lance Eads, R-Springdale, said the change would put states such as Arkansas in a tough spot.
"We're trying to do what we can in this community to provide access to people," he said. "That [change] would definitely be a challenge for a lot of people."
NW News on 06/25/2017