I 
112TH CONGRESS 
1ST SESSION H. R. 1035 
To amend title IV of the Personal Responsibility and Work Opportunity 
Reconciliation Act of 1996 to permit Medicaid coverage for citizens 
of the Freely Associated States lawfully residing in the United States 
under the Compacts of Free Association between the Government of 
the United States and the Governments of the Federated States of 
Micronesia, the Republic of the Marshall Islands, and the Republic of 
Palau. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 11, 2011 
Ms. HIRONO (for herself, Mr. FALEOMAVAEGA, Ms. HANABUSA, and Ms. 
BORDALLO) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend title IV of the Personal Responsibility and Work 
Opportunity Reconciliation Act of 1996 to permit Med-
icaid coverage for citizens of the Freely Associated States 
lawfully residing in the United States under the Com-
pacts of Free Association between the Government of 
the United States and the Governments of the Federated 
States of Micronesia, the Republic of the Marshall Is-
lands, and the Republic of Palau. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicaid Coverage for 
Citizens of Freely Associated States Act of 2011’’. 
SEC. 2. MEDICAID COVERAGE FOR CITIZENS OF FREELY AS-
SOCIATED STATES. 
(a) IN GENERAL.—Section 402(b)(2) of the Personal 
Responsibility and Work Opportunity Reconciliation Act 
of 1996 (8 U.S.C. 1612(b)(2)) is amended by adding at 
the end the following new subparagraph: 
‘‘(G) MEDICAID EXCEPTION FOR CITIZENS 
OF FREELY ASSOCIATED STATES.—With respect 
to eligibility for benefits for the designated Fed-
eral program defined in paragraph (3)(C) (re-
lating to the Medicaid program), section 401(a) 
and paragraph (1) shall not apply to any indi-
vidual who lawfully resides in 1 of the 50 States 
or the District of Columbia in accordance with 
the Compacts of Free Association between the 
Government of the United States and the Gov-
ernments of the Federated States of Micro-
nesia, the Republic of the Marshall Islands, and 
the Republic of Palau and shall not apply, at 
the option of the Governor of Puerto Rico, the 
Virgin Islands, Guam, the Northern Mariana 
Islands, or American Samoa as communicated 
to the Secretary of Health and Human Services 
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in writing, to any individual who lawfully re-
sides in the respective territory in accordance 
with such Compacts.’’. 
(b) EXCEPTION TO 5-YEAR LIMITED ELIGIBILITY.— 
Section 403(d) of such Act (8 U.S.C. 1613(d)) is amend-
ed— 
(1) in paragraph (1), by striking ‘‘or’’ at the 
end; 
(2) in paragraph (2), by striking the period at 
the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(3) 
an 
individual 
described 
in 
section 
402(b)(2)(G), but only with respect to the des-
ignated 
Federal 
program 
defined 
in 
section 
402(b)(3)(C).’’. 
(c) DEFINITION
OF QUALIFIED ALIEN.—Section 
431(b) of such Act (8 U.S.C. 1641(b)) is amended— 
(1) in paragraph (6), by striking ‘‘; or’’ at the 
end and inserting a comma; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘, or’’; and 
(3) by adding at the end the following new 
paragraph: 
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