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History of MiCare

The History of MiCare

The Micronesian island governments have long been responsible for providing health care services for the people of the islands under highly subsidized arrangements. As island populations grew, the impact of health care services on the budget became more significant, creating a greater demand not only to maintain health services, but also to share the cost of maintaining health coverage for individuals.

Consequently, The FSM Government created Public Law 3-82, Chapter 4, as part of the FSM Public Services, under Title 52 of the FSM Code. The public law to provide for “National Government Employees’ Health Insurance Plan” was passed in 1984. The original Health Plan was limited to government employees of the FSM National Government, and enrollment remained optional. In 1990, however, FSM Congress expanded the law into Public Law 8-53, which provided further coverage for state government employees and other agencies’ employees throughout the Federated States of Micronesia. The Plan further allows each eligible individual employee to enroll their dependents and member of their household as plan participants.

In 1994, FSM Congress again passed what became PL 8-133 to further extend the health insurance coverage to employees in the private businesses and their dependents to participate. Now MiCare is extending medical coverage to the entire workforce of the FSM, both public and private, for who chose to participate. It has always been the vision of MiCare to extend medical coverage to FSM citizens at affordable rates. In January 2006, a modification was signed into law enabling students to enroll under the Plan. Individuals who, by law, are eligible to enroll under the plan, now include government employees and their dependents, students attending FSM post secondary institutions, former members of the MiCare Plan, and individual employees of the participating entities and their dependents. The participation of eligible individuals in the Plan remained optional since the inception of the program. At the end of fiscal year 2006 the enrollment was 21,716, which was less than 20% of the FSM residents. Since Micare was the only FSM-wide healthcare managed program, it focused on expanding healthcare coverage to more citizens and residents throughout the nation.

In February of 2002, the 12th Congress of the FSM passed what became Public Law 12-77 (2002), which transferred the responsibility of the FSMNGEHIP, now called MiCare, from the Department of Finance and Administration, FSM National Government, to a seven (7) member Board of Directors. The Board of Directors consist of Seven (7) members, four (4) representing each of the FSM four states, one (1) representing the National Government and one (1) representing the private healthcare sector. The seventh (7th) member of the board is the Administrator of the Plan, who is appointed by the Board of Directors, and serves as an Ex Officio Member of the Board. Six members representing the States, the National Government, and the one representing the private healthcare sector, are appointed by the President with confirmation by FSM Congress.

Timeline of Major MiCare Events

Activity Year Legislation Comment
Establishment of NGEHIP under the FSM Department of Finance and Administration December 26, 1984 PL 3-82 Title 52, Chapter 4 of the FSM Code Original Intent: Coverage for National Employees and dependents
Coverage to State Government employees, others 1990 PL 8-53 Coverage extended to State Government Employees & Agencies and dependents and household members
Private Businesses 1994 PL 8-133 Private Businesses employees and dependents
Transferring overall Operation to the Board of Directors with day-to-day is entrusted to an Administrator February 2002 PL 12-77 The name was change to “MiCare”. The new name has not been officially legislated.
Coverage to students in Higher Institutions in the FSM 2006 Full time students with at least 12 credits