Impacts of Immigrant Health Care Policy: Micronesian Immigrants in Hawaii

The immigration policies of the host society and their foreign country relationships contribute to changes in the influx and composition of immigration populations, and the social context of the host society influences integration of new immigrants. Hawaii has been one of the primary destinations for Micronesian immigrants due to its geographic proximity, as well as the unique social entitlement and benefits endowed by the United States due to the Compact of Free Association between the Federated States of Micronesia and the United States. The friendly state health policies and exhaustive efforts of community health workers toward Micronesian immigrants, in particular, have helped them gain access to health care services in spite of their low socio-economic status and the cultural and linguistic barriers. However, in 2009 the State of Hawaii attempted to restrict access to the state’s comprehensive Medicaid (public health insurance) coverage for Compact citizens. This study examines differences in incorporation and integration in health care access of Micronesian immigrants in Hawaii before and after 2009. The interview and brief survey data were collected with Micronesian immigrants and the ethnic community leaders, as well as local health care providers in 2005 and 2013. The results show the notable decrease in seeking professional health care services and increased perceptional barriers (e.g. fear and frustration) to health care access. Suggestions and implications are discussed.