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Hawaii is now accepting Medicaid applications from residents who are citizens of Palau, the Marshall Islands and Federated States of Micronesia.

The change is a result of a bill signed on Dec. 27 by then-President Donald Trump restoring federal Medicaid funding for citizens of Compact of Free Association nations. Medicaid is a federal public health insurance program for low-income people.

The state has already approved 263 Medicaid applications from the Pacific Islander community since Dec. 27, and expects to save at least $18 million with the influx of federal funding.

Meredith Nichols, assistant administrator of the state Medicaid office, said the state encourages COFA citizens living in Hawaii to apply for Medicaid if they need health insurance. Many lost their jobs due to the COVID-19 pandemic shutdowns but haven’t been able to access the same safety net programs as other taxpayers due to their citizenship status.

The community previously had to sign up for insurance on the federal marketplace, with some exceptions.

Compared to signing up for Medicaid, buying insurance through the federal marketplace is more expensive and the process is more complex. There’s only a short time period to apply, whereas Medicaid enrollment can occur any time of the year.

The state is still figuring out if it will be possible to transfer thousands of migrants directly from the marketplace onto Medicaid, Nichols said.

Nichols said she encourages people who need health insurance to sign up, especially because of the ongoing pandemic.

“We want to make sure that people have access to health insurance so that they can see their doctors on a regular basis without worrying if they can afford to see a doctor,” Nichols said.

In Hawaii, non-Hawaiian Pacific Islanders make up more than a quarter of COVID-19 cases despite comprising just 4% of the population. They also are far more likely to lack health insurance than the average Hawaii resident.

The federal restoration of Medicaid access only applies to migrants in the U.S. through the Compacts of Free Association. Immigrants who lack green cards, as well as undocumented Hawaii residents, are still ineligible for Medicaid although the state continues to cover recent immigrants who are elderly, blind or disabled.

Click here to sign up for Medicaid.