Micronesian migrant communities face barriers to health care access, insurance, Medicaid | News

Migrants from all over Micronesia who travel hundreds of miles to Guam for medical care continue to face challenges in accessing care and insurance.

Although Medicaid is available to residents of the Federated States of Micronesia, the Marshall Islands and Palau in January 2021, application and enrollment issues and other barriers prevent access to care.

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Diabetes, cancer, heart disease, stroke and obesity are chronic health problems for many Guam citizens, said Alex Silverio, director of the Guam Junior Health Office at the Department of Public Health and Human Services.

He said: “My brothers and sisters in the Micronesia region are the most affected.

Silverio said patients, especially from other islands in the region, will come to Public Health with manageable conditions that have progressed to the point of being life-threatening and require urgent care.

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Barriers such as language, transportation, low wages and unemployment create problems.

Transportation

If people can’t afford or have limited access to a car, the only alternative is mass transit, which, if available, can be difficult to use.

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To help with this problem, the Mane’lu Micronesian Resource Center One Stop Shop has a vehicle, called the Mobile Access to Information van, that operates every Wednesday.

It gives clients a way to get to treatment centers and offices, said Hideichi Mori, the center’s project coordinator.







20221019 Mañe'lu 01.jpg

Case worker Jaymi Hainrick, left, and project coordinator Hideichi Mori, stand inside the Edimund Wengu Micronesian Learning Center, located inside the Mañe’lu office in Tamuning on Oct. 19, 2022.



The language barrier of immigrants with limited or no English can prevent filling out medical forms and communicating with health care professionals.

Silverio said that while they appreciate the help of organizations like Mane’lu in providing translation, Public Health also needs to hire more doctors, nurses and staff who know the language and culture of their patients.

Work

Unemployment is another problem, because insurance is often provided through employment.

The only other choice is Medicaid or expensive private insurance.

Even if someone has a job, income can limit their access to care.

“Many of our clients have income; however, it is higher than the Medicaid eligibility threshold, but not enough to pay for private insurance if they are not covered by their work,” said Jaymi Hainrick, a case worker at the Micronesian Resource Center.

Medicaid

Sam Ilesugam, a community advocate for Yap residents in the Federated States of Micronesia, where he is from, said Medicaid eligibility has helped.

However, there are problems with the process.

“Even if we can apply now, there is a need to stay for six months,” said Ilesugam. That can be dangerous for migrants who need urgent medical help.

Nedine Songeni, founder of the organization Neechuumeres: Chuukese Women of Guam, said that although her organization and others are making strides in helping people to apply, bureaucracy and registration papers are a major obstacle.

That’s why some people put off the program and wait until they need to go to the emergency room, she said.

To struggle

Kinta Rapun, a 55-year-old Dededo resident of Chuuk, has been struggling to get health care.

“I’m really looking for insurance, I’ve been applying to places like Public Health and reviewing my application and I’ve been waiting for a long time. I really need asthma medicine,” said Rapun.

He lost his job, along with his health insurance, when he was laid off in 2021.

The caregiving job she does doesn’t offer health insurance, and she doesn’t make enough to pay for her own.

She said the Medicaid process was frustrating because of conflicting and confusing application instructions, requiring her to make multiple trips.

“A client will apply for Medicaid, and by the time Public Health has gone through part of the application, other documents may have expired,” Mori said.

For example, he said a pay stub needs to be sent within two weeks, and once that part of the application is processed, it’s three or four weeks later and a new paycheck is needed.

Micronesian Resource Center staff provide insight into how their non-profit organization provides assistance on health-related issues, particularly for members of the Micronesian community.




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