Democratic candidates vow to cover islanders who lost Medicaid

A spokesperson for former South Bend, Ind., Mayor Pete Buttigieg said his campaign was “open to exploring options for this population.” The campaign of Sen. Amy Klobuchar (D-Minn.) didn’t respond to requests for comment.

Rep. Tulsi Gabbard (D-Hawaii), viewed as a longshot for the nomination, has repeatedly introduced or signed on to congressional legislation to restore the islanders’ Medicaid coverage.

The issue has special resonance in Iowa, as an estimated 800 Marshall Islanders have relocated to Dubuque, seeking free or low-cost health care at a clinic that specializes in serving their population. Two presidential candidates — Buttigieg and Marianne Williamson, who has since exited the race — have visited Crescent Community Health Center, the Dubuque-based clinic that provides special care for the islanders, clinic staff told POLITICO.

The United States had pledged that residents of the Marshall Islands, Palau and Micronesia would have access to Medicaid through a 1986 pact known as the Compact of Free Association. The pact was signed about four decades after the United States began using the Marshall Islands for extensive nuclear-weapons testing, which islanders and researchers have linked to myriad cancers and other health problems. However, the 1996 U.S. Personal Responsibility and Work Opportunity Act stripped the islanders of their access to Medicaid, a decision described as a legislative oversight.

A small band of lawmakers in Congress have spent more than a decade working to restore Medicaid coverage for the islanders, who are non-voters. At least 56,000 islanders are estimated to be living, working and studying in the United States.