Fighting for Fairness: Introducing the Medicaid Improvement for Insular Areas Act of 2025
This week, I introduced the Medicaid Improvement for Insular Areas Act of 2025, legislation that aims to right a decades-old wrong in our health care system. Under current law, U.S. territories—the Northern Mariana Islands, Guam, the U.S. Virgin Islands, American Samoa, and Puerto Rico—face arbitrary Medicaid funding caps that do not apply to the states. This has led to chronic underfunding and real barriers to health care access for millions of Americans in the insular areas. My bill – cosponsored by my fellow territorial delegates, Reps. James Moylan (R-GU), Amata Radewagen (R-AS), and Stacey Plankett (D-USVI) – would eliminate those caps once and for all, and ensure that our fellow citizens in the territories are treated equitably when it comes to federal Medicaid support. It would also bring their federal matching rates in line with those of the states, helping local governments better meet the health needs of residents without the constant threat of shortfalls or temporary fixes. We deserve access to quality health care—regardless of where we live. This legislation is a step toward closing the gap and delivering long-overdue fairness to our territorial healthcare systems.