Health care restored for COFA citizens in December 2020 Omnibus COVID Relief Bill. The restoration of Medicaid eligibility to COFA citizens became effective on December 28, 2020.
As of that date, COFA citizens lawfully residing under the Compacts in the 50 states and District of Columbia, and at the option of the Governor of Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, became eligible for Medicaid. COFA citizens continue to be eligible to purchase health insurance plans in the Affordable Care Act Marketplace with the support of subsidies, though many still struggle to afford these plans.