Compact of Free Association Migrants (COFA Migrants), have a unique relationship with the United States that allows them to freely travel without a visa and with no time restraints. This is a result of the U.S.’s engagement with the Pacific that dates back to post-World War II under the Trust Territory of the Pacific.
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA, Pub.L. 104-193, 110 Stat. 2105, enacted August 22, 1996) changed the law so that COFA Migrants would not be eligible (“not qualified”) for Medicaid, a federal means-tested program.
Under the Children’s Health Insurance Plan Reauthorization of 2009, states have the option to obtain federal matching dollars for covering “lawfully residing” children and pregnant women regardless of date of entry and without any waiting period. Currently, several states cover these populations to varying degrees.
For public benefits purposes, Citizens of the Freely Associated States fall under the category of “not qualified” immigrants. Despite maintaining migration privileges under the Compact, citizens of the Freely Associated States are not qualified for federal benefits since they are neither U.S. citizens nor nationals.
The governments of Hawaii, Guam, Commonwealth of the Northern Mariana Islands and American Samoa receive Compact Impact Aid (Public Law 108-188, December 17, 2003 for FSM and RMI; Public Law 99-658, November 14, 1986 for ROP) to offset any “costs incurred by affected jurisdictions as a result of increased demands placed on health, educational, social, or public safety services or infrastructure related to such services.”
Most COFA Migrants have settled in the Pacific region, likely because the environments and climates are similar to their home nations. Hawaii is home to 12,215 COFA Migrants; Guam, 18,305; and the Commonwealth of the Northern Marianas Islands, 2,100. COFA Migrants are also on the continental United States, including California, Oregon, Washington, and Arkansas – a state where they have been specifically recruited as laborers.
The Health Services costs between 2004-2010 shows that Hawaii reported a total of $238 million, Guam with a total of $65 million and the Commonwealth of the Northern Mariana Islands at $11 million.