Congress passes $168 Million in Medicaid funds for American Samoa

Pago Pago, AMERICAN SAMOA — Congress has passed historic legislation that for the first time in 33 years, gives American Samoa and the other U.S. territories, a statutory increase in their annual Medicaid block grants and lowered the local match requirement. The legislation now goes to the President who is expected to sign it.

For FY2020 and FY2021, American Samoa will receive $84 million a year subject to a federal matching percentage of 83%. Because American Samoa has a presumptive eligibility model that does not do individual eligibility and enrollment, the actual Federal Medicaid Assistance Percentage (FMAP) for the territory will be approximately 64% for federal match and 36% for local match. This is a significant increase from the regular 55% federal match and 45% local match the territories received under the 2011 Affordable Care Act.

In the future, if American Samoa chooses to transition to individual eligibility and enrollment, the FMAP will be at 83% with a local match of only 17%.

Governor Lolo Matalasi Moliga stated, “I am filled with deep gratitude to all the Congressional committees, the territorial Delegates, and authorizing and appropriations committees professional staff that have helped us achieve this monumental step in our Medicaid program. This legislation is an astounding and deserving accomplishment for our government that has worked for the past several years to educate Congressional members and committees on the challenges that American Samoa faces due to the insufficient Medicaid block grants and the high FMAP local match requirement.

“Special thanks go also to our Delegate in Washington, Congresswoman Aumua Amata for her support in our efforts for Medicaid,” he said.

Over the past two years on behalf of the American Samoa Government, Medicaid director Sandra King Young, has held numerous meetings with House and Senate committee staff to explain the impact of the ACA Medicaid funding cliff that expired in September 2019.

Since 2015, American Samoa through the Governor’s office, has been requesting a permanent solution to increase the territories block grant and alleviate the burden of the high local FMAP. Together with the other territorial governors, Governor Lolo has been at the forefront of a territorial lobbying effort to increase the annual block grants and lowering of the local match requirement.

From national interest organizations like the National Association of Medicaid Directors (NAMD), King Young has served for 5 consecutive years being the voice of the territorial Medicaid directors within NAMD bringing the weight and influence of NAMD before Congressional committees on behalf of the territories. Their unwavering advocacy helped to bring about two Congressional hearings and eventually legislation specifically aimed at increasing the territories’ block grants and improving the FMAP for the territories.

Governor Lolo stated, “Finally, I want to express our appreciation for the unwavering lobbying efforts of our Medicaid representative in Washington, D.C., Bettilou Taylor of Taylor Strategies, for her fine work on the Medicaid cap and FMAP issues. We would not have achieved all that we have without her strategic guidance and commitment to American Samoa.”

In October 2019, the American Samoa Medicaid State Agency was forced to suspend all new Medicaid services due to the expiration of the 2011 ACA funding. Now with the availability of the $84 million, the new services added by Medicaid can resume in 2020.

King Young stated with cautious optimism, “Our work is not done. This is only a temporary 2-year fix and we need to keep up our efforts to ensure that we get a permanent funding mechanism for American Samoa’s Medicaid block grant as well as the other territories. But for the moment, we will savor this great achievement as a step in the right direction. I want to thank everyone for their uplifting support in our long fight for this funding. We have much to be thankful for this Christmas season.”