Madam Chair, I have an amendment at the desk. Madam Chair, I rise today to offer an amendment that increases funding for the Marianas Medicaid block grant. Our islands were struck by two catastrophic weather events late last year. Typhoon…
Madam Chair, I have an amendment at the desk.
Madam Chair, I rise today to offer an amendment that increases funding for the Marianas Medicaid block grant.
Our islands were struck by two catastrophic weather events late last year. Typhoon Mangkhut made landfall September 10, and on September 29 the President declared a major disaster for the islands of Saipan, Tinian, and Rota.
While recovery from Mangkhut was still ongoing, super Typhoon Yutu, the second most powerful storm ever in United States history, struck. Yutu caused widespread destruction of homes, businesses, public facilities, and infrastructure. On October 26, the President declared a second major disaster for our islands.
Yutu also brought death.
Never in anyone's memory has a typhoon caused death in our islands, but one person died during Yutu and another in a storm-related accident. Over 130 people were injured.
Our only hospital, which has just 75 beds, packed people into the emergency room to stitch up wounds; remove glass and flying debris from legs, arms, and faces; and attend to those who needed dialysis or other treatment, while waiting days for power to be restored.
Medicaid provides one-quarter of the revenue for the hospital and health insurance for 30 percent of our population, but there is a cap on how much Medicaid funding is available to the Marianas. When a storm strikes, the program has to steal from tomorrow to pay for today.
The disaster appropriation the House passed on December 21, generous though it was, provided no money for Medicaid for the Marianas.
Chairwoman Lowey, recognizing the lapse, added $20 million in H.R. 268 for the Marianas Medicaid program to be available for the rest of the year. After her bill was drafted, however, the Centers for Medicare and Medicaid Services, CMS, informed appropriations staff that the Marianas can actually use $36 million in the wake of the typhoons.
Following that advice from CMS, I am offering an amendment that adds $16 million to the original bill, bringing total assistance for the rest of the year to the recommended $36 million.
Madam Chair, I ask my colleagues for their support of my amendment and of the underlying bill, H.R. 268. The $36 million I am requesting, by adding $16 million to the $20 million already in the bill, is what CMS told Chairwoman Lowey's staff that the Marianas can spend this year in the aftermath of Typhoon Mangkhut and super Typhoon Yutu.
Madam Chair, I include in the Record a recent news report, ``From Something to Nothing,'' published in the Honolulu Civil Beat.
`From Something To Nothing': Life In Saipan After Super Typhoon Yutu
(By Anita Hofschneider)
Chalan Kanoa, Saipan.--Elkanah Igisaiar watches her
daughter climb onto an old car and lift herself up onto the
branches of a tree. It's late afternoon on the Wednesday
before Christmas and Igisaiar is sitting in a plastic chair
outside at her family's compound in this tiny village in
southern Saipan.
The cluster of homes down the street from the island's
cathedral is where her family has lived for generations.
But since Super Typhoon Yutu blew through her neighborhood
in October, her mother's house is uninhabitable--and their
street is now a cluster of tents.
``Most of us are not really ready to talk about the
storm,'' says Igisaiar, 27. ``We are just kind of in
disbelief that we went from something to nothing.''
Two months after the worst storm to hit the U.S. since
1935, thousands of people like Igisaiar are still sleeping in
tents or outdoors. They're waiting for electricity to go back
on. And they are wondering how they'll afford to rebuild
their homes even if they are lucky enough to get some federal
aid.
Despite the severity of the storm, there's been little news
media coverage of what life is like in its aftermath. The
islands are thousands of miles away from the mainland U.S.
and the storm had only one reported casualty.
But the low death toll belies how drastically Yutu
continues to affect thousands of people.
Before Yutu, there were fewer than 100 homeless people
sleeping outdoors on the island of Saipan, the capital of the
U.S. Commonwealth of the Northern Mariana Islands. Despite
widespread poverty--more than half of the community was below
the U.S. poverty line and the median income was $19,201 in
2016--it was rare to see people living in tents.
But overnight, the storm displaced an estimated 15,000 to
17,000 people, more than a quarter of the commonwealth's
population of about 55,000 people.
Severe storms are common in the Mariana Islands, an
archipelago in the western Pacific that includes Guam. Three
years ago, another storm downed half of Saipan's power poles,
leaving some families without electricity for three months.
The expectation that every year will bring extreme weather
events means government buildings and schools are built from
concrete to withstand strong winds.
More than 80 percent of houses had concrete walls as of
2016, and more than half had concrete roofs. Locals are well-
versed in the annual rituals of buying nonperishable food,
filling buckets of water and boarding up windows to protect
them from flying debris.
But Yutu exceeded expectations.
Its 180-mph sustained winds with gusts over 200 mph broke
the National Weather Service's wind instruments, flipped over
containers and ripped off thousands of roofs. Families hid
beneath cabinets, under beds and inside bathrooms to stay
safe. Even elderly people who had survived countless typhoons
on the islands say they feared for their lives. One woman was
killed by a collapsing building.
Igisaiar was in her second-floor apartment during the
storm, watching roofs flying off her neighbors' homes. She
saw one family trying to escape their house, temporarily
blocked by a huge piece of tin that flew onto their doorway.
As they crawled underneath to get out, Igisaiar's boyfriend
went downstairs to urge them to hide in their apartment.
By the time the sun rose, Igisaiar says several neighbors
were sheltering with her, her boyfriend and four children.
The storm damaged so many public schools that students
didn't have classes for more than a month and still only have
half-days. The tourism-based economy came to a standstill,
with fewer than 6,000 visitors in November, down from 48,000
the previous year.
Two months later, debris has been cleared from many
villages and the economy is rebounding. It's once again
common to see tourists on the sidewalks and their bubble-gum-
colored convertible rental cars on the roads.
But on the southern side of Saipan and throughout the
neighboring island of Tinian, families are still sifting
through the wreckage of their lives, sleeping outdoors and
waiting for the electricity to be turned back on. The storm
destroyed or severely damaged more than 5,000 houses, some of
which were home to multiple families.
And unlike disasters on the U.S. mainland, victims can't
just drive to the next county to find another place to live.
There aren't enough undamaged units on the islands of
Saipan and Tinian to house everyone who has been displaced.
Instead of handing out rental subsidies like they did after
Hurricane Michael and Hurricane Florence, federal disaster
responders have passed out more than 1,700 tents along with
military rations.
``When you've been hit like this, things get real primal
real fast and we understand that so our objective is to
provide a safe and sanitary living arrangement,'' says Victor
Inge, a FEMA spokesman based on Saipan.
The housing shortage is so severe that FEMA is calling
families and offering to buy them plane tickets out of the
islands. So far, 29 households have taken advantage of the
program and have booked tickets to Hawaii and other states.
But even though more than 3,600 people are eligible to
leave, the vast majority are choosing to stay. Igisaiar's
family is Carolinian, an indigenous Micronesian community
that sailed in canoes to the Marianas in the 19th century
after a typhoon devastated the Caroline Islands.
Although Yutu was the worst storm she's seen in her life,
Igisaiar says she wouldn't leave the Marianas even if FEMA
gave her money to do so.
She doesn't want her kids to miss more school. She's
worried about their house.
``If we leave, there's nothing that can be done with our
house,'' Igisaiar says. ``If we go, how are we going to get
the assistance?''
The Hazards of Cleaning Up
Igisaiar felt lucky at first. She didn't lose her roof. But
the next day she says her landlord asked her to move out
anyway because of the hazards posed by the damaged apartment
building.
They took just their clothes and one bed, leaving their
children's beds and their refrigerator. They drove to what
was left of the house of her mother, Rufina Angui, in Chalan
Kanoa.
The U.S. military built the house out of wood and tin 30
years ago after Typhoon Kim destroyed the previous house,
Rufina Angui says.
Angui was 27 then. Now 57, it's the first time in her life
that she's been homeless. The heat and the mosquitoes aren't
the only challenge--the lack of power means she can't use the
breathing machine she relies on to help with her sleep apnea.
Angui only recently moved back to the house and started
sleeping in the tent. During and immediately after the
typhoon, she stayed at her brother's house, which is
concrete, while Igisaiar and her boyfriend tried to fix up
the Chalan Kanoa house.
It was too dangerous to sleep inside the broken house at
first, so Igisaiar and her boyfriend lay pallets outside and
secured a tarp over them to block the rain. Igisaiar's
boyfriend, a construction worker, missed work for three weeks
to help clean up. They stacked plywood, tin and debris in
separate piles along the roadside.
Even though there were shelters available, they slept
outside and cleaned. They worried about missing their FEMA
inspection if they weren't around. Plus, who would fix up
what was left of the house if they weren't there?
But increasingly Igisaiar realized fixing the house was an
impossible task. The mold made her sick--it started with a
cough but progressed to a sinus infection until she couldn't
hear or smell well.
When Angui saw her three weeks after the storm, her
daughter was so weak that she was having a hard time
breathing. Igisaiar didn't want to leave her kids, but Angui
convinced her to go to the hospital.
Exacerbating Poverty
The first 24 hours after the storm, no one went to the
emergency room of the hospital on Saipan. And then suddenly
the ER was flooded with twice as many patients as on a normal
day--so many that there weren't enough beds in the ER.
The flow of injuries has slowed over the past two months
but hospital officials say that the disaster has illuminated
the major gaps in health care coverage. Temporary clinics set
up in devastated villages revealed that nearly half of
patients were uninsurable because they were guest workers,
undocumented immigrants or citizens of Pacific island nations
who are ineligible for Medicaid.
Esther Muna, the CEO of the local public hospital, says
she's currently most worried about mental illnesses. She's
seen patients with post-traumatic stress disorder and
depression and says there's been a spate of recent suicides.
Food safety is another concern. Commonwealth officials say
they had just reached
their goal of providing 24-hour water to all villages on
Saipan in September, and storm damage has set them back
again.
Many locals say that the U.S. government's response to Yutu
is much better than it was for Soudelor, another powerful
storm that hit Saipan three years ago.
But a speedy recovery is hindered by the islands' distance
from the rest of the U.S. The Mariana Islands are at least an
eight-hour flight from Hawaii, not including a stop in Guam.
Disaster responders have to ship in everything from concrete
poles to tents, lumber, tin, wire, transformers, even screws.
It's even harder to reach the island of Tinian, which is
between Guam and Saipan and home to about 3,500 people,
similar to the island of Lanai in Hawaii.
The entire island was engulfed by the eye of the storm. At
the commuter airport on Saipan that facilitates flights to
Tinian, airplanes were destroyed, preventing travel for days.
Passengers now buy tickets from a makeshift airport building
made out of containers and tents.
Staff of the Tinian Health Center, an outpost of the public
hospital, hid in the radiology room to survive the storm.
Ninety percent of the 35-member staff lost their homes, Muna
says.
things could be worse
Things have been a lot easier ever since Igisaiar got back
from the ER. She wishes she remembered the name of the doctor
who helped her and got her family a tent to sleep in.
Sleeping inside the tent is a huge improvement over
sleeping under the tarp, even though it's hot during the day.
Life now consists of waiting. Waiting until FEMA tells her
mother and aunt how much money they qualify for, waiting
until they can figure out what to do with the house and how
much it will cost to rebuild it.
She's thought about selling her families' goats--they have
seven, with names like Olaf and Elsa. But she wants to keep
them because her kids love them. Plus, in Carolinian culture
you're supposed to value gifts more than things you buy.
She thought about applying to FEMA for funds to make up for
losing their cell phones and appliances when their apartment
flooded during the typhoon. But she decided against it.
``For me, those are nothing,'' she says. ``There are other
people that just totally lost everything so why not give it
to the people that need it the most?''
She did apply for money from the Red Cross and used the
$750 to buy school supplies and clothes for her kids.
Every morning, she goes to buy ice so that her kids can
have cold water. She spends the day watching her children and
helping her mom. They have even started volunteering at Empty
Vessel, a Christian social service organization that hands
out clothes to those in need.
Angui says she's tired of eating canned goods, but the
family knows it's lucky to have food stamps.
``We're not hungry,'' Angui says.
Madam Chair, I yield 1 minute to the gentlewoman from Connecticut (Ms. DeLauro).
Madam Chair, I have no further statements to make. I ask for support of my amendment and the underlying bill, H.R. 268, and I yield back the balance of my time
Madam Chair, I have an amendment at the desk.
Madam Chair, my second amendment to this Supplemental Appropriations Act increases emergency food assistance for the Marianas.
As I explained earlier, our islands were struck by not one, but two typhoons last year, one right after another--Typhoon Mangkhut and Super Typhoon Yutu, the second most powerful storm ever in U.S. history.
Within the first 30 days after Yutu, our local food stamp program had incurred costs of $10.2 million. That money helped families replace the food they lost in the storms when their homes lost roofs and water poured in and electricity and refrigeration were cut off.
Over 40,000 people, out of our total population of 54,000, received help in that first month, according to the Department of Agriculture's Food and Nutrition Service. H.R. 268 replaces that first month's expenditure with an appropriation of $10.2 million.
I thank Chair Lowey for recognizing the need, but beyond that first month of emergency, more is needed.
The Marianas is not part of the Supplemental Nutrition Assistance Program, SNAP. Instead, we receive a block grant from the Federal Government. With the block grant, there is no reserve, as with SNAP. When disaster strikes, not only is money used up faster than planned on the front end, future costs also rise until families get back on their feet.
Madam Chair, I have no official projection of the ongoing costs, because Agriculture employees are furloughed. But just before the lights went out, my staff learned that about 20 percent of the people who received food assistance right after the storm were expected to remain eligible.
If these projections hold true, total caseload will double from 3,000 households to 6,000 households. The $15 million in my amendment will provide a little over 6 months of funding for those newly eligible households until their incomes can recover.
If $15 million proves too generous, which I very much doubt, the Secretary has authority to grant only as much as needed to respond to the disaster caused by Typhoon Mangkhut and Super Typhoon Yutu. I ask my colleagues for their support of my amendment and of H.R. 268.
Madam Chair, again, because the Marianas is not part of SNAP, there is no contingency funding to absorb the costs of this disaster. With more families eligible for assistance, unless we make more funds available, benefits will have to be cut across the board. That is not a right way to respond when people are trying to put their lives back together so they can support themselves and their families again.
Madam Chair, I ask my colleagues to support my amendment making another $15 million available so these families have enough food. I urge your support for the underlying bill as well, and I yield back the balance of my time