SB 706, known as the COFA Medicaid Outreach Bill, is a legislative initiative designed to address healthcare disparities among residents living in the United States under the Compact of Free Association (COFA). These individuals—primarily from the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau—have historically faced unique legal hurdles in accessing federal benefits.
The primary goal of SB 706 is to ensure that COFA citizens are successfully enrolled in Medicaid (known as Medi-Cal in California or OHP in Oregon) and understand their restored eligibility for full-scope coverage.
Key Provisions of SB 706
- Targeted Outreach: The bill mandates the creation of culturally and linguistically specific outreach programs. This includes funding for community-based organizations (CBOs) that have established trust within COFA communities.
- Education and Enrollment Assistance: It provides resources to help individuals navigate the complex application process, specifically addressing the transition from state-funded “bridge” programs back into the federal Medicaid system.
- Language Access: Requires that all communication, forms, and digital portals regarding Medicaid eligibility are available in the primary languages of COFA citizens (such as Marshallese, Chuukese, and Palauan).
- Data Tracking: The bill often includes requirements for state health departments to track enrollment rates within these specific populations to measure the effectiveness of the outreach.
Why the Bill Was Needed
For over two decades, a “drafting error” in the 1996 Welfare Reform Act stripped COFA citizens of their eligibility for federal Medicaid, despite their legal right to live and work in the U.S. and their history of military service.
- Restoration of Rights: In late 2020, federal law restored Medicaid eligibility for COFA citizens.
- The Information Gap: Despite the change in law, many families remained unaware that they were now eligible for full coverage or feared that applying might impact their immigration status.
- Health Disparities: COFA communities experience disproportionately high rates of chronic conditions (like diabetes and heart disease) due to the history of U.S. nuclear testing in the Pacific, making consistent healthcare access a matter of restorative justice.
Current Status (2026 Context)
As of 2026, many states with high Pacific Islander populations (such as Hawaii, Oregon, and Washington) have used SB 706 or similar legislative frameworks to finalize the transition of COFA residents into permanent Medicaid categories.
Note: While the federal H.R. 1 (The “One Big Beautiful Bill” Act) has recently introduced new work and renewal requirements for Medicaid nationwide, SB 706 serves as a shield to ensure COFA citizens do not lose their hard-won coverage due to these new administrative hurdles.
