Micronesians Win Major Victory in Hawaii’s U.S. District Court

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BY MALIA ZIMMERMAN – HONOLULU, HAWAII – U.S. District Judge Michael Seabright said today that he will grant an injunction against the state of Hawaii’s Department of Human Services and order that the state restore health benefits to legal aliens equivalent to what other Hawaii resident beneficiaries receive.

Hawaii Attorney Paul Alston brought a class action lawsuit against the state after the Hawaii Department of Human Services downgraded the benefit structure for adult legal aliens unable to qualify for the federally funded Medicaid coverage.

His clients included some of the 7,500 low-income adults from Micronesia, the Marshall Islands and Palau who migrated to Hawaii legally under the Compacts of Free Association (COFA) between Micronesia and the U.S. government.

Alston, who filed the lawsuit in partnership with former State Attorney General Margery Bronster, challenged the state on the claims that his clients’14th Amendment Rights (the Equal Protection Clause), were violated when the state reduced their medical coverage.  The judge’s injunction is a victory for his clients struggling with life threatening conditions and need chemotherapy and dialysis, which are unavailable in Micronesia, Alston says.

The controversial change that Alston’s team challenged came on July 1, 2010, when DHS launched “Basic Health Hawaii” – or what the state called “a less comprehensive health plan for legal aliens” in the US for 5 years and COFA immigrants.

Though she did not want to comment immediately today about the court ruling, Department Director Lillian Koller explained in July: “Hawaii taxpayers have generously provided health care and other social services to COFA migrants for many years, even though this is clearly a 100 percent federal responsibility because the U.S. government used their island nations for nuclear weapons testing during the 1940s and 1950s. “The State of Hawaii undeniably should receive full federal reimbursement for all the services we provide to COFA migrants, yet we only receive about ten cents on the dollar,” Koller said. “Unfortunately, Congress continues to ignore our State’s repeated requests for relief.” …  this lingering economic downturn makes it untenable for the State to continue shouldering a federal responsibility.”

Hawaii currently spends an estimated $130 million on COFA migrants, but receives only $11.4 million from the federal government to cover the costs. The change from “Medicaid like benefits” to Basic Health Hawaii saved Hawaii taxpayers an estimated $8 million a year, the DHS reported.

While Alston realizes the coverage adds an additional burden to Hawaii taxpayers, he says the decision is a life saving one for some of his clients who need more than 12 doctor visits and four prescriptions allowed currently under the Basic Health Hawaii program.

Lead plaintiff Tony Korab, for example, is 58, has had heart bypass surgery, needs regular dialysis for his failing kidneys, and is taking 16 prescription medications per month. A citizen of the Republic of the Marshall Islands, Korab cannot receive this costly medical treatment at home where there is no dialysis treatment available.  In 1999, in search of affordable and accessible medical care, he moved to Hawaii for the medical benefits.

There are thousands of legal migrants like him. An estimated 12,215 aliens now reside in Hawaii via COFA. They moved here without VISAs, in most cases to take advantage of free healthcare, public education, low-income housing and other social services. These legal immigrants comprise less than 1 percent of the population, but consume more than 20 percent of Hawaii’s social services, according to state estimates.

State Deputy Attorney General John Molay sought to have the case dismissed, however U.S. District Judge Michael Seabright refused the state’s motion on November 10.

The defendants and the state will need to reach an agreement by Friday as to how and when the benefits will be restored, with priority going to those who are more critically ill. If an agreement is not reached, Molay says that the parties will meet Monday at 2:30 p.m. in Seabright’s chambers to determine the next course of action.

Whether or not the case will further is in the hands of the next governor and his attorney general. Democrat Gov.-elect Neil Abercrombie will be sworn in on December 6, 2010. His attorney general pick has not been announced.

“We all agree that it is best if the federal government stepped forward to bring in more money to the state (for COFA coverage). We will have to see whether the next governor will have more success than the current governor. That is something we hope will happen as Hawaii citizens and taxpayers,” Alston says.

State and Federal taxpayers – and legal immigrants throughout the country – may be impacted by a decision made in Hawaii.

Attorneys in Massachusetts and other states with large legal immigrant populations are paying attention to the Hawaii case.

While Alston says technically this ruling does not impact any other state directly, there are other states with similar issues already citing the Hawaii case and lawyers there who may be encouraged to file lawsuits arguing that “Seabright got it right.” Alston’s team also may expand their challenge to include non-COFA legal aliens excluded from medical coverage because they have been in the United States less than 5 years.

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