Entry #7: COFA continued

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The Free Associated States or COFA nations.
The 2009 Children’s Health Insurance Program Reauthorization Act gave states the authority to extend Medicaid and CHIP benefits to lawfully residing children, including COFA migrants, and provided federal matching funds to offset the cost. Approximately half of the US states have adopted the provisions  (McElfish et al. “Effect of US Health Policies”). The two states with the largest Marshallese populations have very different health care support for Marshallese.  Hawaii has always provided health insurance through its state funds for Marshallese and other COFA children. In stark contrast, Arkansas does not provide any health insurance for COFA children. In order for Marshallese children who live in Arkansas to get CHIP benefits, “the Arkansas state government would need to submit a state plan amendment to the Center on Medicare and Medicaid Services and obtain approval. At present, Arkansas has not submitted such an amendment and has shown no intent to do so. Therefore, Marshallese migrant children residing in Arkansas remain ineligible for CHIP coverage  (McElfish et al.).

McElfish, Pearl Anna, et al. ““Just doing the best we can”: health care providers' perceptions of barriers to providing care to Marshallese patients in Arkansas.” NCBI,4 May 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215735/. Accessed 28 October 2023.



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