Micronesia, the Marshall Islands, and Palau are among the smallest countries in the world. In fiscal year 2017, the three FASs had a combined resident population of approximately 175,000 (102,622 in Micronesia; 54,354 in the Marshall Islands; and 17,901 in Palau). Interior’s Office of Insular Affairs (OIA) has primary responsibility for monitoring and coordinating U.S. assistance to the FASs, and State is responsible for government-to-government relations. The U.S. relationship with the FASs began when American forces liberated the islands from Japanese control near the end of World War II. In 1947, the United States entered into a trusteeship with the United Nations and became the administering authority over Micronesia, the Marshall Islands, and Palau. Voters approved the Constitution of the Federated States of Micronesia in 1978 and approved the Constitution of the Marshall Islands in 1979. Both Micronesia and the Marshall Islands remained subject to the authority of the United States until 1986, when a compact of free association went into effect between the United States and the two nations. The Palau constitution took effect in 1981, and Palau entered into a compact of free association with the United States in 1994. Micronesia and Marshall Islands became members of the United Nations in 1991, while Palau joined the organization in 1994. Under its compacts with Micronesia, the Marshall Islands, and Palau, the United States provided economic assistance that includes access to certain federal services and programs, among other things, for defined time periods. Economic assistance to Micronesia and the Marshall Islands. The 1986 compact of free association between the United States and Micronesia and the Marshall Islands, respectively, provided about $2.6 billion in funding for fiscal years 1987 through 2003. In 2003, the United States approved amended compacts of free association with the two countries. According to Interior, economic assistance under the amended compacts is projected to total $3.6 billion, including payments for compact sector grants and trust fund contributions for both countries in fiscal years 2004 through 2023. Funding under the original compact and amended compacts has been provided to Micronesia and the Marshall Islands through Interior. Economic assistance to Palau. The compact of free association between the United States and Palau entered into force in 1994 and provided $574 million in funding through Interior for fiscal years 1995 through 2009 for assistance to the government, contributions to a trust fund, construction of a road, and federal services. In September 2010, the United States and Palau signed an agreement that would, among other things, provide for additional assistance to Palau, including contributions to its trust fund. The 2010 agreement and subsequent amendments entered into force in September 2018. According to Interior, direct assistance to Palau under the compact will total $229 million for fiscal years 2010 through 2024, including $105 million that Congress provided in annual appropriations in fiscal years 2010 through 2017. Under the compacts, the United States has responsibility for defense and security matters in, and relating to, each of the FASs, and subsidiary agreements pursuant to the compacts provide for U.S. military use and operating rights in these countries. According to the Department of Defense, the compacts have enabled it to maintain a critical strategic position in the Indo–Pacific region. The compact with the Marshall Islands also provided for a separate agreement that constituted a full and final settlement of all claims resulting from U.S. nuclear tests conducted in the Marshall Islands during the period 1946 through 1958. In addition, a subsidiary agreement with the Marshall Islands secured the United States’ access to the U.S. military facilities on Kwajalein Atoll, which are used for missile testing and space tracking activities. Under the compacts, eligible FAS citizens are exempt from certain visa and labor certification requirements of the Immigration and Nationality Act as amended. The migration provisions of the compacts allow eligible FAS citizens to enter the United States (including all states, territories, and possessions) and to lawfully work and reside in the United States indefinitely. The implementing legislation for the 1986 compact with Micronesia and the Marshall Islands stated that it was not Congress’s intent to cause any adverse consequences for U.S. territories and commonwealths and the state of Hawaii. The legislation further declared that Congress would act sympathetically and expeditiously to redress any adverse consequences. In addition, the legislation authorized compensation to be appropriated for these areas that might experience increased demands on their educational and social services from compact migrants from Micronesia, the Marshall Islands, and Palau. The legislation required the President to report and make recommendations annually to Congress regarding adverse consequences resulting from the compact and provide statistics on compact migration. In November 2000, Congress made the submission of annual reports about the impact of compact migration in affected jurisdictions—that is, compact impact reports—optional and shifted the responsibility for preparing these reports from the President to the governors of Hawaii and the territories. In December 2003, Congress took steps in the amended compacts’ implementing legislation to address compact impact in designated U.S. areas. The legislation restated Congress’s intent not to cause any adverse consequences for the areas defined as affected jurisdictions— Hawaii, Guam, the CNMI, and American Samoa. In addition, the legislation authorized and appropriated funding for compact impact grants to the affected jurisdictions, to be allocated on the basis of the proportion of compact migrants living in each jurisdiction. Further, the legislation required an enumeration of compact migrants to be undertaken at least every 5 years. The legislation also permitted affected jurisdictions to submit compact impact reports to the Secretary of the Interior. The implementing legislation for the amended compacts authorized and appropriated $30 million for each fiscal year from 2004 through 2023 for grants to the affected jurisdictions. According to the legislation, the grants are provided to aid in defraying costs incurred by these jurisdictions as a result of increased demand for services due to the residence of compact migrants. OIA reviews the affected jurisdictions’ annual proposals for the use of the funds and provides the funds to the jurisdictions as compact impact grants. The grants are to be used only for health, educational, social, or public safety services or for infrastructure related to such services. Figure 1 shows the locations of the FASs and the affected jurisdictions. The implementing legislation for the amended compacts requires Interior to conduct an enumeration of compact migrants, which is to be supervised by the Census Bureau or another organization selected by Interior, at least every 5 years beginning in fiscal year 2003. On the basis of these enumerations, each affected jurisdiction is to receive a portion of the annual $30 million appropriation in proportion to the number of compact migrants living there. The legislation permits Interior to use up to $300,000, adjusted for inflation, of the annual appropriation for compact impact to conduct each enumeration. The amended compacts’ implementing legislation defines a compact migrant, for the purposes of the enumeration, as “a person, or their children under the age of 18, admitted or resident pursuant to [the compacts] who as of a date referenced in the most recently published enumeration is a resident of an affected jurisdiction.” Compact migrants have varying eligibility for certain U.S. federal government programs. Eligibility for some federal programs changed as a result of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act. For example, when the compacts were signed, FAS citizens were eligible for Medicaid; however, the act removed this eligibility. Table 1 shows compact migrants’ eligibility status for selected federal benefit programs as of November 2019. From 2009 to 2018, the number of compact migrants living in U.S. states and territories rose by an estimated 68 percent, from about 56,000 to about 94,000. In 2011, we reported that combined data from the Census Bureau’s 2005-2009 American Community Survey and 2008 enumeration showed an estimated 56,345 compact migrants living in U.S. areas. During the period 2013 to 2018, an estimated 94,399 compact migrants lived in U.S. areas, according to combined data from the Census Bureau’s 2013-2017 American Community Survey and 2018 required enumeration in Guam, the CNMI, and American Samoa. This estimate includes Micronesian and Marshallese citizens who entered the United States after 1986, Palauan citizens who entered the United States after 1994, and certain U.S.-born children younger than 18 years. Data from the 2013-2017 American Community Survey and the 2018 enumeration indicate that an estimated 50 percent of compact migrants lived on the U.S. mainland and an estimated 49 percent lived in the affected jurisdictions during this period: 26 percent in Hawaii, 20 percent in Guam, and 3 percent in the CNMI. This estimate indicates growth in the number of compact migrants on the U.S. mainland since 2011, when we reported that the Census Bureau estimated 58 percent of compact migrants lived in the affected jurisdictions. The Census Bureau estimated that 11 states in the U.S. mainland, in addition to three of the four affected jurisdictions—Hawaii, Guam, and the CNMI—had compact migrant populations of more than 1,000, according to the 2013-2017 American Community Survey and the 2018 enumeration (see fig. 2). Stakeholders we interviewed—including FAS embassy and consular officials, FAS community members, state government officials, and representatives of private sector and nonprofit organizations—expressed concerns about the Census Bureau’s prior estimates of compact migrants. Some Arkansas stakeholders cited other, higher estimates of the FAS population in their state. Moreover, some stakeholders said that compact migrant populations are apprehensive or distrustful about being formally counted through surveys or the census. Stakeholders also noted that some compact migrant communities have felt frustrated at having been encouraged to respond to surveys and be counted but not experiencing any benefit from these efforts, according to a nonprofit official and FAS community members. Marshallese consular officials said that they believed the 2010 census undercounted their citizens, noting that the Census Bureau did not employ any Marshallese surveyors in the Arkansas counties with Marshallese populations. Stakeholders also expressed concern about the decennial census to be conducted in 2020, which, like the 2010 decennial census, will collect information on race. Nonprofit organization officials whom we interviewed expressed concern that the 2020 census could result in an undercounting of compact migrants because of language barriers and compact migrants’ difficulty accessing the census form online. Arkansas health care and private sector representatives and the Marshallese consulate described plans to address barriers to obtaining a more accurate count of the population in the 2020 census. Hawaii is making a statewide effort to ensure that compact migrants are counted in the 2020 census, according to Hawaii state officials. According to Guam officials, an outreach effort in Guam has leveraged “trusted voices,” or parties known to compact migrant communities there, to communicate the importance of responding to the 2020 census. Data from the American Community Survey showed an estimated 72,965 compact migrants living in the 50 states, the District of Columbia, and Puerto Rico in 2013 through 2017. An estimated 31,425 compact migrants living in these areas (43 percent) were U.S. citizens. The remaining estimated 41,540 (57 percent) were not U.S. citizens. The U.S. citizens who were counted included naturalized citizens and minor-age U.S. citizen children of compact migrants, who would no longer be counted as compact migrants after reaching 18 years of age. An estimated 25,555 compact migrants living in these areas were born in Micronesia; 20,545 were born in the Marshall Islands; and 3,435 were born in Palau. These totals do not include compact migrants born in the FAS and living in Guam, the CNMI, or American Samoa, because the American Community Survey does not cover these territories. An estimated 27,735 compact migrants living in these areas who were 18 years and older (69 percent) were in the civilian labor force. Of those, 24,540 (89 percent) were employed and 3,195 (12 percent) were unemployed. An estimated 1,660 compact migrants living in these areas—4 percent of compact migrants 17 years and older—were on active duty in the U.S. military or had served on active duty in the past. For additional American Community Survey data on compact migrant demographics, see appendix IV. Compact migrants move to U.S. areas for a range of reasons, including greater economic and educational opportunities, better access to health care, a desire to join family members in the United States, and a wish for greater personal freedom. In some communities we visited, stakeholders noted that FAS citizens had come to the United States for school or work before the compact with Micronesia and the Marshall Islands and the compact with Palau went into effect but that the compacts had opened the option of migration to a broader range of individuals. Economic opportunities. Compact migrants described moving to U.S. areas for better, more reliable jobs and higher wages. Having a better-paying job in the United States sometimes allows individuals to send remittances or consumer goods to family members living in an FAS. Other compact migrants move to U.S. areas to join the military. Educational opportunities. Compact migrant families often move to U.S. areas so that their children will have access to improved primary and secondary education, according to compact migrants. Some compact migrants travel to U.S. areas to attend college and choose to stay to work, including to pay off their student loans, according to consular officials and compact migrants. Health care access. Compact migrants sometimes migrate to U.S. areas to obtain medical treatment for themselves or family members, according to FAS community members and consular officials. Some medical procedures or treatments, such as dialysis or access to specialists, are not available in the FASs, according to federal and nonprofit officials. Family. Many compact migrants relocate to the United States to join family members and communities already living there, according to consular and nonprofit officials. Personal freedom. Some compact migrants said that they have more personal, social, and cultural freedom in the United States than in their more traditional home country. Changes in the natural environment in the FASs have also prompted migration from those areas, according to FAS representatives. Depleted food resources and effects of climate change—including more-frequent typhoons, coral reef bleaching, and depletion of fishing stocks—have contributed to migration, according to an FAS official. In addition, members of Marshallese communities cited rising sea levels and frequent tidal flooding as reasons for migrating from the Marshall Islands to U.S. areas. Some Marshallese community members also noted that the legacy of U.S. nuclear testing had contributed to their decision or need to move. Compact migrants cited varied reasons for choosing to migrate to specific locations. For example, representatives of FAS communities in Guam and the CNMI noted the FASs’ closer proximity to those territories than to the U.S. mainland as well as the similarity of Guam’s and the CNMI’s island cultures to those of their home countries. Also, some compact migrants in Arkansas and Oregon cited the lower cost of living and a perception of less discrimination or greater safety there than in Hawaii. Marshallese community members often migrate to Arkansas for jobs in the poultry industry. Consular officials noted that, because of comparatively lower wages and fewer housing options in the FASs, returning to their countries after living in U.S. areas can be difficult for some compact migrants. Some compact migrants said that it is also difficult to find a good job in their home countries without family or political connections. According to an FAS official, some compact migrants retire to their home countries. However, several compact migrants we spoke with said they planned to stay in U.S. areas to be close to medical care or to children and grandchildren born there. The affected jurisdictions of Hawaii, Guam, and the CNMI reported estimated compact impact costs (i.e., costs incurred as a result of increased demands on public services from compact migrants) that totaled $3.2 billion during the period fiscal years 2004 through 2018 and increased over time for Hawaii and Guam. Interior has provided compact impact grants totaling more than $30 million annually to the affected jurisdictions, each of which uses the funds differently. In October 2019, Census discovered an error in the 2013 and 2018 enumerations, which Interior had used to determine the distribution of compact impact grant funds and which resulted in misallocation of these funds for fiscal years 2015 through 2020. In February 2020, Interior officials told us that the department had developed a modified plan for compact impact grants in fiscal years 2021 through 2023 that, according to the officials, is intended to correct the misallocation. Hawaii, Guam, and the CNMI reported a total of $3.2 billion in estimated compact impact costs during the period fiscal years 2004 through 2018, with estimated annual costs increasing over time for Hawaii and Guam and fluctuating for the CNMI. Hawaii reported $1.8 billion in total estimated compact impact costs. Hawaii’s reported annual costs increased from $55 million in fiscal year 2004 to $198 million in fiscal year 2018. Guam reported $1.2 billion in total estimated compact impact costs. Guam’s reported annual costs increased from $33 million in fiscal year 2004 to $147 million in fiscal year 2017. The CNMI reported $116 million in total estimated compact impact costs. The CNMI’s reported annual costs amounted to $10 million in both fiscal year 2004 and fiscal year 2018 but fluctuated over time, ranging from a low of about $3 million in fiscal year 2011 to a high of $12 million in fiscal year 2014. For a summary of the estimated compact impact costs reported by the three affected jurisdictions, see figure 3. For more details of their compact impact reporting, see appendix V. The three affected jurisdictions reported compact impact costs for education, health, public safety, and social services (see table 2). As the table shows, the highest total costs in fiscal year 2017 were for education and health services. In November 2011, we found that Interior’s reporting to Congress on compact impact had been limited, and we identified weaknesses in existing compact impact reporting. We found that some jurisdictions did not accurately define compact migrants, account for federal funding that supplemented local expenditures, or include revenue received from compact migrants. Our November 2011 report recommended that the Secretary of the Interior disseminate guidelines to the affected jurisdictions that adequately addressed concepts essential to producing reliable impact estimates and that the Secretary call for the use of these guidelines in developing compact impact reports. Although Interior developed a draft of compact impact reporting guidelines in 2014, it had not disseminated such guidelines to the affected jurisdictions as of February 2020. In 2019, Interior awarded the Guam government a technical assistance grant for $280,000 to conduct a cost-benefit analysis to determine compact migrants’ economic contribution to the local economy. The effort will reportedly also seek to address weaknesses and methodological concerns related to compact impact costs calculated by Hawaii, Guam, and the CNMI. Guam officials said that the grant application was prepared in response to our prior critique of their compact impact estimation methodology. The grant was awarded to the Guam Bureau of Statistics and Plans, which contracted with University of Guam consultants to carry out the work beginning in October 2019. Guam officials expected this work to result in two reports—one identifying economic contributions by compact migrants (expected September 2021) and another proposing a methodology for determining compact impact costs (expected August 2022). During fiscal years 2004 through 2019, Hawaii, Guam, and the CNMI received a combined total of approximately $509 million in compact impact grant funding. This total includes (1) annual compact impact grant funding allocated from $30 million authorized and appropriated in the amended compacts’ implementing legislation and (2) additional compact impact grant funding allocated from annual appropriations. In fiscal years 2004 through 2019, Interior made annual allocations of the $30 million of compact impact grant funds authorized and appropriated in the amended compacts’ implementing legislation. Interior provided these allocations as compact impact grants to each affected jurisdiction to defray their costs due to the residence of compact migrants. Interior used the four most recent enumerations— conducted in 2003, 2008, 2013, and 2018—as the basis for these annual allocations. Since fiscal year 2012, Interior has provided additional compact impact grant funding to the affected jurisdictions from annual appropriations. This additional funding has ranged from approximately $3 million to $5 million per year since fiscal year 2012. Interior has allocated the additional funding on the basis of the 2013 and 2018 enumerations. Table 3 shows the total amounts that Hawaii, Guam, and the CNMI received as compact impact grant funding in fiscal years 2004 through 2019. Affected jurisdictions use their compact impact grant funding in varying ways and report on their use of the funds to Interior. Hawaii allocates the entirety of its compact impact grant—approximately $13 million annually since fiscal year 2015—to the state’s MedQuest division to defray costs of providing medical services to compact migrants. Guam has used some of its approximately $15 million of compact impact funding each year for new schools constructed through leasebacks (see fig. 4 for photos of several schools built by the Guam government with compact impact funds). The CNMI allocates its approximately $2 million of compact impact funding each year across the education, health care, public safety, and social service sectors. Hawaii, Guam, and CNMI officials have emphasized that compact impact funding does not fully compensate for the expenses associated with compact migration. For stakeholder suggestions related to compact impact funding and other issues, see appendix VII. In October 2019, Census Bureau officials discovered an error in the 2013 and 2018 Census Bureau enumerations that caused inaccurate counts of compact migrants in Hawaii and, according to Interior officials, resulted in misallocation of compact impact funding for Hawaii, Guam, the CNMI, and American Samoa in fiscal years 2015 through 2020. Relative to the proportion of compact migrants in each jurisdiction, allocations to Hawaii were a total of $16.9 million lower than they would have been without the enumeration error while allocations to Guam, the CNMI, and American Samoa were higher than they would have been without the error. Table 4 summarizes the under- and overpayments of compact impact funding to each affected jurisdiction that, according to Interior officials, resulted from the enumeration error. The enumeration error was discovered in late October 2019, near the beginning of fiscal year 2020. As of February 2020, OIA officials had developed a modified planned allocation of compact impact funds for fiscal years 2021 to 2023. Beginning in fiscal year 2021, OIA plans to divide the $30 million of annual compact impact grant funding in fiscal years 2021 through 2023 using corrected base allocations from the updated 2018 enumeration from Census Bureau, according to an Interior preliminary assessment. The base allocations will be adjusted upward for Hawaii and downward for Guam, the CNMI, and American Samoa to correct for the erroneous payments in fiscal years 2015 through 2020. See table 5 for a comparison of the originally planned fiscal year 2020 allocation (based on the erroneous enumeration) and the revised allocation (based on the corrected enumeration) as well as the grant amounts that OIA proposed for fiscal years 2021 through 2023 to correct for the erroneous payments. The governments of some of the U.S. areas we visited identified effects of providing public education and health care services to compact migrants. Compact migration’s effects in U.S. areas we visited also include budgetary contributions from compact migrants’ payment of taxes and fees as well as budgetary costs of other government programs and services to compact migrants. Stakeholders in the U.S. areas additionally discussed the participation of compact migrants in those areas’ workforces and communities in terms of contributions and impacts of compact migration. Children of compact migrants attending U.S. public primary and secondary schools sometimes receive additional or specialized services, such as support for English language learners, according to state and territorial officials. In the U.S. areas we visited, state and territorial departments and school districts have identified and counted compact migrant students by means of one or more criteria, including ethnicity, language, and place of birth. See table 6 for estimated numbers of compact migrant students in the states and territories we visited and the criteria that each state or territory used to count students as compact migrants. Compact migrants are eligible for in-state tuition at some U.S.-based colleges and universities, according to university, nonprofit, and state officials. For example, in Guam, compact migrants attending the University of Guam are eligible for in-state tuition. In Oregon, FAS citizens are eligible for in-state tuition after a 1-year residency period in the state, according to nonprofit officials. In Arkansas, Marshallese citizens are eligible for in-state tuition after a 3-year residency period in the state, according to state tuition policy and officials. States and territories have reported budget and program effects related to health care for compact migrants who are eligible for federal benefits as well as health care for individuals, including compact migrants, who are ineligible for federal benefits and lack private insurance or other means of payment. U.S. area governments sought to enable compact migrants’ access to health care in several ways, including extending access to the federal Children’s Health Insurance Program (CHIP) or Medicaid and leveraging federal health insurance tax credits and other federal funding. According to some U.S. area government officials, some of these programs are provided specifically because compact migrants are ineligible for certain programs at the federal level. Extended Access to Children’s Health Insurance Program or Medicaid The Children’s Health Insurance Program Reauthorization Act of 2009 included an option for states to cover children younger than 21 years and pregnant women in both CHIP and Medicaid who are lawfully residing in the United States—a definition that includes compact migrants—and who are otherwise eligible under the state plan. Therefore, in some U.S. areas, non-U.S. citizen compact migrants who are children or pregnant may access federal health insurance coverage through CHIP or Medicaid. As of February 2020, 38 states and territories and the District of Columbia had extended such coverage to lawfully residing non–U.S. citizen pregnant women or children, including compact migrants, who met all other eligibility requirements (see fig. 5). According to Arkansas officials, their state’s decision to extend this coverage was sought in part to address unmet needs of compact migrants living in Arkansas. Subsidized Coverage in Patient Protection and Affordable Care Act Exchanges Compact migrants are eligible to purchase individual market health insurance plans through health insurance exchanges established under the Patient Protection and Affordable Care Act (PPACA). Individuals purchasing coverage through the exchanges may be eligible, depending on their incomes, to receive financial assistance in the form of premium tax credits to offset the costs of their coverage. Premium tax credits, which are designed to reduce an eligible individual’s premium costs, may be either paid in advance on a monthly basis to an enrollee’s issuer (referred to as advance premium tax credits) or received after the individual files federal income taxes for the prior year. Some state governments have elected to cover the remaining balance of some individuals’ exchange plans, leveraging a combination of advance premium tax credits and state funds to fully cover health insurance premiums on certain exchange plans. For example, Hawaii created the Health Care Premium Assistance Program, a special state program that covers the cost of premiums on eligible plans for qualified residents who do not qualify for Medicaid. While Hawaii’s program was not created specifically in response to compact migration and is not limited to compact migrants, most of its enrollees are compact migrants, according to Hawaii government officials. Since its launch in 2015, the program pays the balance of health insurance premiums not covered by advance premium tax credits for those who would otherwise be qualified for federal Medicaid if not for their citizenship status, including compact migrants. According to state officials, the program covered 3,223 compact migrants residing in Hawaii as of June 2017. Oregon and Washington developed premium assistance programs specific to compact migrants that leverage advance premium tax credits to eliminate health care premium costs. In addition to covering premiums, these programs provide for out-of-pocket health care costs, according to the programs’ websites and state officials. Oregon COFA Premium Assistance Program. The Oregon COFA Premium Assistance Program was launched in 2017, expressly to help compact migrants gain access to health care. In Oregon, participants pay for out-of-pocket costs at the time of service and subsequently apply to the program for reimbursement. Oregon’s program covered 780 compact migrants as of October 2019, according to state officials. The officials estimated that this program leverages $9 of federal funds through advance premium tax credits for every $1 of Oregon state funds contributed. Washington COFA Islander Health Care. The Washington COFA Islander Health Care program was launched in 2019, expressly to help compact migrants gain access to health care, and was based in part on the Oregon program, according to state officials. Washington will also cover dental insurance costs for compact migrants beginning in 2021, according to the program’s website and state officials. Participants in Washington’s program receive a payment card with preloaded funds to use for out-of-pocket costs. The program covered approximately 1,100 compact migrants in 2019, according to state officials. (Fig. 6 shows an example of an advertisement for Washington’s program, presenting information in six languages spoken by compact migrants.) Additional Federal Health Care Funding in U.S. Territories All U.S. territories, including Guam and the CNMI, receive federal funding through Medicaid, which is subject to an annual cap. Section 2005 of the PPACA, as amended, increased the funding caps for the territories for the period beginning on July 1, 2011, and ending on September 30, 2019, and provided a total of $6.3 billion in additional federal funding for health care to the territories. Guam and the CNMI have used some of this funding, in addition to other federal funding for health care, to partially support compact migrants’ health care costs or to alleviate the burden on programs that cover compact migrants. Guam. PPACA Section 2005 funding partly alleviated the financial shortfall of Guam’s Medically Indigent Program, according to a territory official. The Medically Indigent Program pays for health care costs of primarily non-U.S. citizens living in Guam, including compact migrants, who do not have other health insurance. Most compact migrants in Guam qualify for this program after meeting the 6-month residency requirement, according to Guam officials. In fiscal year 2019, compact migrants participating in the program numbered 8,616, according to Guam officials, and made up 73 percent of the program’s total participation. The officials said that the program is also funded through Guam local appropriations and federal Medicaid Undocumented Emergency Services funding. CNMI. Territorial hospital officials said that PPACA Section 2005 funding available in fiscal years 2011 through 2019 partially covered patient care costs in excess of the territory’s annual Medicaid cap, including care for compact migrants. The CNMI Medicaid program uses federal Disaster Relief Assistance funding to reimburse the hospital for emergency services provided to compact migrants, according to CNMI officials. Other Health Care Services Available to Compact Migrants Non-U.S. citizens, including compact migrants, may access health care through the U.S. Department of Health and Human Services Health Resources and Services Administration’s Health Center Program and through state government–supported clinics. The Health Center Program was established in the mid-1960s to help low-income individuals gain access to health care services. Health centers are responsible for delivering affordable, accessible, high-quality, comprehensive primary health care regardless of recipients’ ability to pay, according to Department of Health and Human Services officials. Figure 7 shows the entrance to Kokua Kalihi Valley, a federally qualified health center in Honolulu that estimates one-third of its patient population to be compact migrants, mostly from Micronesia. State clinics provide health services such as screening and treatment of certain infectious diseases to compact migrants, among other state residents. For example, the Arkansas Department of Health established the Dr. Joseph Bates Outreach Clinic to provide public health services to Marshallese in the region. As of September 2019, approximately 95 percent of the clinic’s patients were Marshallese, according to clinic officials. In addition, the University of Arkansas for Medical Sciences Northwest Campus facilitates research and community health programs in the Marshallese community and has established a clinic focused on diabetes. The budgetary effects of compact migration in the U.S. areas we visited include contributions by compact migrants, such as payment of federal and state taxes and fees, and also include several types of government program costs related to compact migration. Budgetary contributions. Compact migrants pay payroll taxes, including income taxes, and contributions to Social Security and Medicare. They also pay fees associated with state or territorial documentation or licensing, including driver’s licenses. In general, reliable data on budgetary contributions of compact migrants are not available, because state and territorial tax filings and related databases do not provide data on citizenship or ethnicity, according to state and territorial officials. However, the Hawaiian government reported that in 2017, compact migrants generated an estimated $36.6 million in state revenue from fees and taxes, such as the individual income tax, general excise taxes, and taxes generated from state government spending. According to University of Guam officials and an FAS community member, the presence of FAS communities may have helped Guam institutions obtain funding, including funding for research. Budgetary costs. State and territorial officials identified budgetary costs related to compact migration. For example, officials cited costs of providing translators or interpreters for government programs and costs associated with compact migrant interactions with police and the justice system. Some states have elected to extend state-level programs for food or cash-based assistance to compact migrants who are ineligible for the federal equivalents. For example, Washington’s Cash Assistance and Food Assistance Programs provide financial support to FAS citizens who are ineligible for the federal Supplemental Nutrition Assistance Program and Temporary Assistance for Needy Families. In Guam, some compact migrants qualify for the federal earned income tax credit, according to officials of Guam’s Department of Revenue and Taxation. The officials noted that because Guam’s tax system mirrors the federal system, any earned income tax credit paid in Guam is an expense to the territorial government. Compact migrants are eligible to work in U.S. areas and have contributed to the workforces of receiving communities, holding jobs in a range of industries. According to stakeholders we interviewed, compact migrants have encountered challenges while participating in the workforce. In the U.S. areas where they reside, compact migrants participate in the local economies in part by serving in the workforce in a variety of fields, including manufacturing, service industries, and professional industries, according to stakeholders we interviewed. See table 7 for examples. The following describes compact migrants’ participation in the areas we visited. Arkansas. Arkansas private sector representatives described Marshallese workers as essential to poultry plant operations, comprising one-quarter to one-third of some plants’ workers. At one such plant, most Marshallese employed are line workers on the floor of the plant, while others work as trainers and translators. Other compact migrants in Arkansas work at an airport; in hotels; in retail; or as caregivers, including in adult day care, according to FAS consular officials and nonprofit representatives. CNMI. CNMI officials and a private sector representative described compact migrants as a valuable resource in supplementing the CNMI’s small labor pool. Officials also noted that without compact migrants, businesses would have to recruit more foreign labor and face more-severe hiring challenges than they do now. Officials and a private sector representative stated that several businesses and franchises were founded by, and employ, compact migrants. Guam. Guam Chamber of Commerce representatives indicated that compact migrant workers would not be easily replaced if they were no longer eligible to work in Guam and that hiring other foreign workers in Guam involves difficult visa processes. Compact migrants tend to hold entry-level and low-skill jobs in Guam and have high turnover rates, according to representatives from one company. Several businesses in Guam were founded by, or cater to, compact migrants, according to private sector representatives. Hawaii. Micronesian officials noted that established communities of compact migrants in Hawaii help other FAS citizens to migrate, network, and find job opportunities. FAS community members in Hawaii identified multiple local businesses that either are owned by compact migrants or employ a large number of compact migrants. Oregon. In Oregon, some compact migrants work as caregivers or in a plant manufacturing reusable plastic containers for food storage and transport, according to an FAS official and community members. Oregon state government officials noted that compact migrants play an important role in working with adults and children with intellectual and developmental disabilities and in other paid caregiver capacities. The Governor of Oregon noted that compact migrants bring a tremendous amount of value to Oregon communities as educators, social workers, caregivers, and as members of the U.S. military. Other jobs or industries in which compact migrants work include warehousing, fast-food restaurants, and airport jobs, according to FAS officials. Washington. Some compact migrants work in caregiving, including at senior care homes; in manufacturing, warehousing, fast-food restaurants, or nonprofits; as artisans; or at airports, according to state and FAS officials and FAS community members. Stakeholders reported that compact migrants have encountered various challenges related to participation in the U.S. workforce. See appendix VII for additional challenges experienced by compact migrant communities. Form I-94. Compact migrants from Micronesia and the Marshall Islands may present an unexpired FAS passport and Form I-94 Arrival/Departure Record (known as Form I-94) to employers to demonstrate their identity and employment authorizations. Before 2013, compact migrants entering the United States received a paper copy of the form to document their legal entry and their ability to legally reside indefinitely in the United States. The DHS transition in 2013 from issuing Forms I-94 on paper to issuing them electronically created challenges for compact migrants, according to FAS community members. According to consulate officials, communities were not adequately notified that DHS would maintain these records in publicly accessible databases for only 5 years. As a result, some compact migrants who entered the United States after mid-2013 did not download their Forms I-94 before they became unavailable and thus did not have a Form I-94 to show to employers, according to stakeholders we interviewed. REAL ID–compliant driver’s licenses. Some employers require employees to have REAL ID–compliant driver’s licenses, according to FAS officials and community members. Before September 2019, DHS required compact migrants and other nonimmigrants applying for a REAL ID–compliant driver’s license to present an unexpired passport with an unexpired visa and Form I-94 or to present an employment authorization document. However, because compact migrants do not receive a visa and are not otherwise required to obtain an employment authorization document, they were unable to obtain the licenses. In September 2019, DHS changed its requirements specifically to allow compact migrants to receive REAL ID–compliant driver’s licenses by presenting an unexpired passport and Form I- 94. Some compact migrants in Guam said that challenges related to REAL ID before the DHS regulation change had negatively affected their employment because some military base jobs required these documents for employment or for base access. In addition, some compact migrants have lost jobs at airports because of difficulty in obtaining REAL ID–compliant identification, according to Marshallese embassy officials. See appendix X for information about legislative and DHS policy changes that affected compact migrants’ ability to access full-term REAL ID–compliant driver’s licenses and identification cards. Commercial driver’s licenses. Various stakeholders discussed difficulties that compact migrants had encountered in obtaining commercial driver’s licenses required by certain jobs and obtaining standard driver’s licenses that are compliant with REAL ID requirements in some states. Marshallese officials said that compact migrants’ inability to obtain or renew commercial driver’s licenses had prevented them from being able to work in related jobs, such as truck driving. Labor abuse and discrimination. In September 2019, the government of Micronesia requested that the Department of State provide assistance to investigate abuse and mistreatment of Micronesian citizens who were recruited to move to the United States to work for a U.S. company in Iowa. In addition, compact migrants in Hawaii, Guam, and Oregon told us that they had faced workplace discrimination or were seen as harming the local economy. For example, compact migrants in Guam said that they had experienced discrimination in hiring and pay and sometimes were made to feel like a burden on the community. Additionally, a March 2019 report by the Hawaii Advisory Committee to the U.S. Commission on Civil Rights concluded that some compact migrants find it difficult to report workplace discrimination because they are concerned about retaliation from employers. The report found, among other things, that compact migrants face discrimination in access to employment and housing and also face widespread negative public perception in Hawaii. Stakeholders expressed some concerns about compact migration with respect to public health and law enforcement interactions. In addition to participating in the workforce, compact migrants participate in social institutions and create diversity and cultural exchange in their receiving communities. State and territorial health department officials and health care providers in the U.S. areas we visited noted concerns about the prevalence of communicable diseases such as tuberculosis and Hansen’s disease in compact migrant communities. Tuberculosis. State and territorial health departments have worked to identify and treat cases of active and latent tuberculosis in compact migrant communities. About 15 to 20 percent of active, communicable tuberculosis cases in Hawaii have occurred in the FAS community, including several cases of antimicrobial drug–resistant variants of tuberculosis, according to Hawaii government officials. In 2019, 23 communicable tuberculosis cases were diagnosed in compact migrants in Hawaii. In Arkansas, public health officials estimated that they had screened 30 percent of the Marshallese population since 2000 and reported 202 active cases and 500 cases of latent tuberculosis infection between 1997 and 2019. Arkansas officials also said that they screened 1,728 Marshallese and reported five cases of active disease and 95 cases of tuberculosis infection in fiscal years 2018 and 2019. In 2017 and 2018, Arkansas officials traveled to the Marshall Islands to conduct screening for active and latent tuberculosis in addition to diabetes and Hansen’s disease. Hansen’s disease. Hansen’s disease affects some members of compact migrant communities, according to health care providers and state government officials. For example, the Hawaii Department of Health has a registry of 281 patients who are on active treatment or monitoring for recurrence of Hansen’s disease or complications from the disease. The department manages 10 to 20 new cases of Hansen’s disease each year. According to Hawaii public health officials, 95 percent of the individuals diagnosed with Hansen’s disease in the state were from the Micronesian or Marshallese communities. From 2003 to 2019, the Arkansas Department of Health reported that 54 individuals, including 42 compact migrants, had been diagnosed with Hansen’s disease. Some stakeholders reported concerns regarding public order and law enforcement interactions with compact migrants in Guam, Hawaii, and Washington. Guam. Guam law enforcement agencies report on crimes committed by, or attributed to, FAS groups in each location. Guam private sector representatives we interviewed expressed a belief that social tension with the FAS communities was driven in part by some compact migrants’ public drunkenness or violence. In addition, language barriers can hinder compact migrants’ social integration into receiving communities, according to Guam law enforcement officials. Hawaii. Common offenses for which compact migrants are cited or arrested in Hawaii include quality-of-life or social-order offenses, such as trespassing, disorderly conduct, drinking in public or driving under the influence of alcohol, assault, or harassment, according to state officials. These interactions with the public or with law enforcement officials may contribute to a strained relationship between compact migrants and receiving communities. Hawaii officials estimated that 20 to 25 percent of the population using the state’s homeless services self-identify as part of the FAS community. Compact migrants may sleep in public parks, which can lead to legal charges. A lack of affordable housing may be a cause for homelessness among FAS communities. Washington. Marshallese embassy officials cited sporadic problems with gang activity and drug use among some younger Marshallese community members, particularly those living in Washington. These officials suggested that some migrant children who feel bullied or pressured may band together, resulting in a negative or gang-like situation. In some U.S. areas we visited, stakeholders we interviewed said that compact migrants seek to contribute to, or engage with, their surrounding U.S. communities through volunteer work, including church activities, environmental work, and other efforts. For example, FAS communities described participating in environmental cleanup efforts, including efforts to control invasive species and leveraging their agricultural knowledge to help Hawaiian farmers grow a more resilient variety of taro. Several community representatives in multiple states noted that some compact migrants spend a significant amount of time supporting their fellow community members as translators or interpreters or volunteering to help others navigate complex systems in U.S. areas. FAS citizens also serve in the U.S. military. The FAS countries have a high rate of military service, according to FAS officials and State documentation. Stakeholders in some U.S. areas we visited described compact migrant populations as contributing to the diversity of receiving communities and educational institutions. For example, University of Guam officials said that FAS student association groups sponsor cultural events and activities that help to define the character of the university. The officials also noted that FAS students contribute to research portfolios and bring FAS government and community perspectives to classroom discussions. The officials observed that the presence of compact migrants increases the university community’s diversity and its cultural awareness and competency. In Arkansas, Marshallese community members said that they had helped to teach local U.S. residents about Marshallese culture and history not otherwise taught in U.S. schools. Marshallese community members in Arkansas also expressed a belief that the community brought a greater emphasis on family and respect for elders to the region. We provided a draft of this report for review and comment to the Departments of Agriculture, Commerce, Health and Human Services, Homeland Security, Housing and Urban Development, the Interior, State, and Transportation; the Social Security Administration; the Governors of Hawaii, Guam, the CNMI, Arkansas, Oregon, and Washington; and the Ambassadors of Micronesia, the Marshall Islands, and Palau to the United States. The Departments of Agriculture, Health and Human Services, Homeland Security, and State and the Social Security Administration provided technical comments, which we incorporated as appropriate. The Departments of Commerce, Housing and Urban Development, the Interior, and Transportation did not provide comments. U.S. areas and the FAS Ambassadors provided written comments that we have summarized below and reproduced in appendixes XI through XIX, and responded to their comments, where appropriate, at the end of those appendixes. Hawaii. The government of Hawaii commented that the health and economic impacts of the coronavirus pandemic, in addition to Hawaii’s high cost of living and public charge concerns, affect the state’s compact migrant communities in particular. The government also observed that racial disparities and other determinants of health and well-being are exacerbated for compact migrants. Noting that compact migrants lack access to Medicaid and the Supplemental Nutrition Assistance Program, the government urged that compact migrants’ access to health care and food nutrition programs be treated as a federal priority. Guam. The government of Guam advocated, in the context of the coronavirus pandemic, for restoring debt relief provisions associated with compact migration to offset unreimbursed compact expenses. The government noted that from the time the compacts went into effect until 1996, FAS citizens maintained access to federal health coverage. The government also commented that in 2017, Interior’s Office of Insular Affairs reported to Congress that restoring this eligibility would be in line with Congress’ intent to never cause adverse consequences to the territories and Hawaii. In addition, the government observed that moving compact migrants from Guam’s locally funded Medically Indigent Program to Medicaid would help Guam provide government services to all residents who need them. The government of Guam noted that the ongoing absence of an agreed definition for compact migrant for the purposes of data collection creates confusion. CNMI. The government of the CNMI commented on the importance of compact migrants’ contributions to the territory’s workforce needs and noted that they enrich the cultural makeup of the CNMI. Separately, the government stated that the response to the enumeration error discovered by the U.S. Census Bureau that led to a misallocation of compact impact funds has penalized the territories. According to Interior’s modified plan, future allocations to the CNMI (in addition to Guam and American Samoa) would be adjusted downward to account for past overpayment. The CNMI commented that reducing the future amounts of compact impact funds because of an error of the federal government does not recognize the present needs of the CNMI. The CNMI government also noted that the territories receive less data collection support from the American Community Survey, the U.S. Bureau of Economic Analysis, and the U.S. Bureau of Labor Statistics than other U.S. areas receive. Arkansas. The government of Arkansas commented that it considered the Census Bureau data in our report to underestimate the compact migrant population in Arkansas, and it cited several higher estimates. The government noted that the state does not receive compact funding, despite its high population of Marshallese, because it is not an affected jurisdiction as defined in the Compacts of Free Association Amendments Act of 2003. The government projected that approximately 12,000 compact migrants reside in Arkansas and estimated its annual costs related to compact migration at about $72 million. We believe that the Census Bureau data are sufficiently reliable for our purposes of estimating the number of compact migrants in U.S. areas. However, our report includes a discussion of stakeholder concerns that the compact migrant population in Arkansas may have been undercounted. We reported that the Census Bureau had estimated the compact migrant population in Arkansas during the period 2013 to 2017 at 5,895 on the basis of the definition of “compact migrants” used for its enumerations—citizens of Micronesia, the Marshall Islands, and Palau who entered the United States after 1986 (from Micronesia and the Marshall Islands) or 1994 (from Palau) and their U.S.-born children (biological, adopted, and step-) and grandchildren younger than 18 years. Oregon. The government of Oregon advocated for more reporting on the effects that U.S. military access to, and U.S. testing of 67 nuclear weapons in, the Marshall Islands has had on compact migration, citing the devastating impact of nuclear fallout on inhabitants’ health and the environment. The government of Oregon also cited a need to report on compact migrants’ positive contributions to receiving areas. Our report provides qualitative descriptions of compact migrants’ contributions, including budgetary, workforce, and social contributions, and also provides high-level data on estimated mean and median incomes among compact migrants. We have incorporated additional statements by the government of Oregon about compact migrant contributions in our report. The government noted that it has taken steps at the state level to provide health care access to compact migrant populations while also urging Congress to restore this populations’ access to federal programs such as Medicaid and Temporary Assistance for Needy Families. Further, the government called on Interior to expand the definition of “affected jurisdiction” and appropriate grant funds equitably. As we note in our report, this definition and the associated grant funding were established by Congress in the amended compacts’ implementing legislation. Washington. The government of Washington commented that our report did not provide a detailed history of U.S. military nuclear testing in the FASs and subsequent impacts on them and their citizens. The government noted that such information is necessary to explain FAS citizens’ current challenges and why additional resources are required to meet their needs. Further, the government commented that our report omits the personal narratives that are critical to a holistic account of the FAS experience in the United States, including the struggles many compact migrants face. Our report incorporates information that we obtained through our interviews with members of compact migrant communities, including those in Washington, such as reasons for migration, workforce and other challenges they faced, and stakeholder suggestions for improving experiences or outcomes of compact migration (see app. VII). The government of Washington stated that it hoped our report would prompt the federal government to make additional resources available to U.S. areas with sizeable compact migrant populations, and it called for inclusion of Washington among affected jurisdictions receiving compact impact grant funding. Micronesia. The Embassy of the Federated States of Micronesia emphasized the importance of quantifying not only costs but also economic benefits of compact migration, including job creation, taxes paid, and community contributions. The embassy also called for guidelines and enumeration methods that better capture actual costs and revenue. The embassy noted the relationship between FAS citizens’ ineligibility for federal programs such as Medicaid and the costs borne by local governments and communities in the absence of these federal programs. According to the embassy, the continuing challenge of Micronesian citizens’ ineligibility for Medicaid since 1996, compounded by the effects of relevant social determinants of health, make their successful integration in U.S. areas more difficult. Noting that these circumstances have a direct effect on Micronesian migrants’ ability to contribute positively in receiving areas and become less reliant on public assistance programs, the embassy expressed support for the restoration of FAS citizens’ eligibility for Medicaid and for expanded veterans’ health care in Micronesia. The embassy commented that compact impact grant funding is a domestic issue and that discussions related to this issue should not diminish the priority of ongoing U.S. assistance to Micronesia under the compact. The embassy also raised concerns about challenges facing compact migrants, including the challenges described in our report. Marshall Islands. The Embassy of the Republic of the Marshall Islands described the migration rights provided in the compact as fundamental and essential to its country’s relationship with the United States. Additionally, the embassy observed that restoring Medicaid eligibility for its citizens living and working in the United States would greatly benefit its citizens and substantially reduce impact costs to certain areas. The embassy noted that, although Marshall Islands citizens living in the United States are eligible to purchase individual market health insurance plans through exchanges established under the Patient Protection and Affordable Care Act, many who are employed lack access to affordable health care because of the limited insurance benefits offered by most service industries or the high cost of covering family members. Furthermore, the embassy called for an objective accounting of revenue received from compact migrants and depiction of their contributions to, for example, the health and food security of the United States through employment in the food processing industry and other essential work. Last, the embassy commented that the addition of Marshallese workers to the 2020 census effort may remedy the potential undercounting of its citizens in the previous census. Palau. The Embassy of the Republic of Palau observed that it would be helpful to know the number of compact migrants from each FAS country who are able to access the federal programs for which they are eligible. This question was outside the scope of our review. Further, the embassy commented that it would like the U.S. federal government to inform and educate state departments of motor vehicles regarding the special status of FAS citizens in the United States, and it highlighted the difficulties that compact migrants historically have faced in obtaining REAL ID–compliant identification. We are sending copies of this report to the appropriate congressional committees and to the Departments of Agriculture, Commerce, Health and Human Services, Homeland Security, Housing and Urban Development, the Interior, State, and Transportation; the Social Security Administration; and the Governors of Arkansas, the CNMI, Guam, Hawaii, Oregon, and Washington; and the Ambassadors of Micronesia, the Marshall Islands, and Palau. In addition, the report is available at no charge on the GAO website at https://www.gao.gov. If you or your staff have any questions about this report, please contact me at (202) 512-3149 or gootnickd@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. GAO staff who made key contributions to this report are listed in appendix XX. We were asked to review topics related to migration to U.S. areas from the freely associated states (FAS)—the Federated States of Micronesia (Micronesia), the Republic of the Marshall Islands (Marshall Islands), and the Republic of Palau (Palau)—under those countries’ compacts of free association with the United States. This report (1) presents estimates of compact migrant populations and describes recent trends in compact migration; (2) summarizes the reported costs related to compact migration (compact impact costs) in three affected jurisdictions—Hawaii, Guam, and the Commonwealth of the Northern Mariana Islands (CNMI); and (3) describes effects of compact migration on governments, workforces, and societies in these and other U.S. areas. To present estimates of compact migrant populations in U.S. areas and describe recent trends in compact migration, we obtained special tabulations of data from the U.S. Census Bureau’s 2013-2017 American Community Survey (ACS) for the 50 U.S. states, the District of Columbia, and Puerto Rico. For Guam and the CNMI—U.S. territories that are not covered by the ACS—we used the Census Bureau’s revised 2018 enumeration of compact migrants in these areas. The special tabulations of ACS data and the Census Bureau’s 2013 and 2018 enumeration reports defined compact migrants as individuals residing in U.S. areas who were born in the FASs and entered the United States after 1986 (for Micronesia and the Marshall Islands) or 1994 (for Palau) and their U.S.-born children (biological, adopted, step-) and grandchildren younger than 18 years. We calculated percentage changes in states and territories that had more than 1,000 estimated compact migrants (or were designated as affected jurisdictions by the 2003 compacts’ implementing legislation) by comparing 2005-2009 ACS data and the 2008 enumeration with 2013-2017 ACS data and the revised 2018 enumeration. To identify and describe changes in Census Bureau methods and definitions for enumerating compact migrants over time (see app. VI), we reviewed the definitions of “compact migrant” in the bureau’s enumeration reports for tabulations before and including 2018. We also interviewed Census Bureau and Department of the Interior (Interior) officials. For example, we asked when and where grandchildren were counted among compact migrants younger than 18 years. To estimate net arrivals to U.S. areas by travelers with FAS passports (see app. III), we analyzed data from the Department of Homeland Security’s (DHS) Customs and Border Protection’s (CBP) Arrival and Departure Information System (ADIS). According to CBP officials, ADIS consolidates data from several DHS systems to create unique, person- centric travel records for all travelers regardless of citizenship. We calculated monthly FAS net arrivals to U.S. areas from 2017 through 2019 by using ADIS data that DHS provided, showing numbers of individuals with FAS-issued passports entering and exiting U.S. ports of entry each month during the period. To assess the reliability of ADIS data, we spoke with DHS officials to identify potential data reliability concerns and other limitations of ADIS. Officials said that any compact migrant who enters on an FAS passport and holds U.S. citizenship will be masked or not appear in the ADIS system. Officials also said that compact migrants who become U.S. citizens after arrival or are later discovered to be U.S. citizens are removed from the data; CBP officials believed these numbers to be small. We also conducted statistical checks for consistency and completeness of the ADIS data, including validating the ADIS data against publicly available passenger data from the U.S. Department of Transportation Air Carrier Statistics (TranStats) T-100 database for 2015 to 2019 (data for 2019 were partial). We used flight segment data from the T-100 database containing total passenger counts reported by both U.S. and foreign air carriers for flights that compact migrants take to U.S. areas. We found that data from ADIS and the T-100 database were positively correlated for 2015, 2017, 2018, and 2019 but were not correlated for 2016. According to CBP officials, ADIS was significantly changed in 2016 and may contain duplicate entries for that year. As a result, we determined that ADIS data for 2017 and later were sufficiently reliable for our intended use. To quantify costs related to compact migration that were reported by the affected jurisdictions included in our review—Hawaii, Guam, and the CNMI—we reviewed documents that they had published or provided to Interior, such as compact impact reports submitted by Hawaii and Guam and grant documents submitted by the CNMI. We used the most recent data available for 2004 through 2018. To identify the amount of funding distributed by Interior as compact impact grants to the affected jurisdictions, we interviewed Interior officials and reviewed relevant documentation. To identify and describe effects of compact migration on governments, workforces, and societies of receiving U.S. areas, we reviewed relevant documentation and conducted interviews with stakeholders in six U.S. areas that we visited. Documentation that we reviewed included program information and counts of compact migrants using state-level benefits programs, treated by state or local health clinics, enrolled in public schools or higher-education institutions, or using interpreters. Because various sources may define compact migrants by ethnicity, place of birth, language of origin, or other metrics, we noted the definition used for each count in this report. To identify the eligibility of compact migrants for selected federal programs, we reviewed relevant statutes and regulations and held discussions with officials from the U.S. agencies that oversee the programs. We selected the programs included in table 1 on the basis of those we included in a prior report, and we added other selected programs that we learned about in the course of interviews for our current report. We traveled to, and interviewed stakeholders in, six U.S. states and territories where compact migrants live, including three of the U.S. areas designated in the 2003 amended compacts’ implementing legislation as affected jurisdictions—Hawaii, Guam, and the CNMI— and three mainland states—Arkansas, Oregon, and Washington. We selected these areas on the basis of previously reported compact migrant population distributions in U.S. areas and of the locations of consulates or honorary consuls established by Micronesia, the Marshall Islands, and Palau. Stakeholders we interviewed included officials from nine federal agencies; state and territorial government officials in areas we visited; private sector and nonprofit organization representatives such as chambers of commerce, employers of compact migrants, and nonprofit service providers; officials from the FAS embassies and consulates or honorary consuls in areas we visited; and compact migrants living in areas we visited (see table 8). FAS embassy officials in Washington, D.C., connected us with local community members who helped us promote and organize the local community meetings in areas we visited. Participants whom we interviewed in the meetings do not represent a generalizable sample of compact migrants, and the challenges they discussed are not comprehensive (see app. VII for a discussion of challenges faced by compact migrants, according to stakeholders we interviewed). To describe academic studies of workforce and fiscal impacts of new migrants (see app. IX), we conducted a search, using keywords relevant to the economic impact of migration, in American and European economics academic journals published during the period 2015 to 2019. We reviewed a subset of these articles that we deemed most relevant to the context of compact migration, including articles that related to migration of lower-skilled workers and that included empirical analysis of the impact of this migration on various economic aspects. We also reviewed survey articles reviewing the conclusions of prior relevant publications. We conducted this performance audit from March 2019 through June 2020 in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objectives. We believe that the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives. Table 9 presents Census Bureau data for U.S. states and territories that had estimated compact migrant populations of more than 1,000 in 2013 through 2018 and shows percentage changes in these populations from 2005-2009 to 2013-2018. Data for U.S. areas not covered by the American Community Survey, including Guam, the Commonwealth of the Northern Mariana Islands (CNMI), and American Samoa, are from compact migration enumerations that the Census Bureau performed on behalf of the Department of the Interior. According to 5-year data from the Census Bureau’s 2013-2017 American Community Survey, 72,965 compact migrants resided in the 50 U.S. states, the District of Columbia, and Puerto Rico. (The American Community Survey does not cover American Samoa, the CNMI, Guam, or the U.S. Virgin Islands.) For estimates of the number of compact migrants in each of the 50 U.S. states, the District of Columbia, and Puerto Rico, see table 10. The American Community Survey captures, among other things, respondents’ place of birth (by country) and state of residence. Table 11 provides Census Bureau estimates, using 2013-2017 American Community Survey data, of the numbers of compact migrants born in the freely associated states—the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau—and residing in each of the 50 states, the District of Columbia, and Puerto Rico. From 2017 through 2019, an average of about 366 more migrants from the Federated States of Micronesia (Micronesia), Republic of the Marshall Islands (Marshall Islands), and Republic of Palau (Palau) arrived in U.S. areas per month (4,390 per year) than departed, according to the Department of Homeland Security’s Customs and Border Protection’s Arrival and Departure Information System (ADIS). As figure 8 shows, this trend was driven by migrants from Micronesia and the Marshall Islands (3,343 and 1,487 per year on average, respectively). Each year during this period, an average of about 440 more Palauan citizens departed from the United States than arrived. The Census Bureau’s American Community Survey is an ongoing survey that provides information on a yearly basis, including employment status, educational attainment, veteran status, and age of survey respondents, among other topics. The survey covers the 50 U.S. states, the District of Columbia, and Puerto Rico. (The survey does not cover American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, or the U.S. Virgin Islands.) Some data for compact migrant populations are available through the American Community Survey. See table 12 for demographic information about compact migrant populations in the 50 U.S. states, the District of Columbia, and Puerto Rico in 2013 to 2017. See table 13 for demographic information about the compact migrant population in Hawaii only. Since 1986, Hawaii, Guam, and the Commonwealth of the Northern Mariana Islands (CNMI) have submitted to the Department of the Interior (Interior) intermittent compact impact reports and other documents that include descriptions of, and estimated costs for, education, health, public safety, and social services that local government agencies provided to compact migrants. Hawaii and Guam have submitted compact impact reports, which are available on Interior’s Office of Insular Affairs’ website. The CNMI has not submitted a compact impact report since fiscal year 2003 but reports compact impact costs to Interior in the CNMI’s annual plan for the use of compact impact grants. Table 14 shows the estimated costs that these affected jurisdictions reported to Interior or provided to us for 1986 through 2018. The Census Bureau, working under an interagency agreement with the Department of the Interior (Interior), has conducted six sets of enumerations of compact migrants in affected jurisdictions for the purpose of allocating compact impact grant funding and has performed the enumerations every 5 years. Enumeration methods and definitions have changed over time. During the course of our work, an error was discovered that affected the accuracy of the 2013 and 2018 enumerations and also affected Interior’s allocations of compact impact grants for several fiscal years. Census Bureau methods of gathering new data or analyzing existing data for compact migrant enumerations on behalf of Interior have changed over time. In 1993,1998, and 2003, the bureau used the “snowball” technique; in 2008, 2013, and 2018, the bureau employed a two-pronged approach. For enumerations in 1993, 1998, and 2003, the Census Bureau employed a survey method known as snowball sampling to count compact migrants in Hawaii, Guam, and the Commonwealth of the Northern Mariana Islands (CNMI). Because the surveys relied on referrals by respondents to identify new respondents, they were likely to undercount compact migrants who were not referred. For the enumerations in 2008, 2013, and 2018, the Census Bureau used a combination of existing and new survey data to count or estimate the numbers of compact migrants in Hawaii, Guam, and the CNMI. However, for the enumerations in Hawaii, the bureau used a different approach than it used for the enumerations in Guam and the CNMI. Also, for the enumerations in Guam and the CNMI, the bureau used a different approach in 2013 than it used in 2008 and 2018. To estimate the number of compact migrants in Hawaii, the Census Bureau used existing American Community Survey data. To estimate the numbers of compact migrants in Guam and the CNMI, the bureau used existing decennial census data in 2013 and gathered new survey data in 2008 and 2018. See table 15 for a summary of the enumeration methods that the Census Bureau has used over time. The definition of “compact migrant” that the Census Bureau used for the enumerations has changed over time. Each enumeration has counted as a compact migrant any individual, of any age, who was born in the Federated States of Micronesia (Micronesia), the Republic of the Marshall Islands (Marshall Islands), or the Republic of Palau (Palau) and who entered the United States after the effective date of their country’s compact. However, the enumerations in 2003, in 2008, and in 2013 and 2018 used various criteria for counting U.S.-born (U.S. citizen) individuals as children of compact migrants and therefore as compact migrants. 2003 enumeration. The definition of “compact migrant” in the 2003 amended compacts’ implementing legislation indicates that the children of compact migrants were to be considered compact migrants until 18 years of age. Interior interpreted the legislation’s definition of “compact migrant” as including all children younger than 18 years who were born to a compact migrant or migrants in the United States, thus including some U.S. citizens. 2008 enumeration. For the 2008 enumeration, the Census Bureau, on behalf of Interior, counted as compact migrants all children (biological, adopted, and step-) younger than 18 years who were born in the United States to a compact migrant head of household or to his or her spouse, were adopted by a compact migrant head of household or by his or her spouse, or were stepchildren of a compact migrant head of household or of his or her spouse. 2013 and 2018 enumerations. Starting with the 2013 enumeration, the Census Bureau also began counting as compact migrants all children (biological, adopted, and step-) younger than 18 years who were born in the United States to a compact migrant or to his or her spouse, regardless of whether they were the children of the head of household or of his or her spouse, and all grandchildren of a compact migrant who were younger than 18 years, regardless of whether they were the grandchildren of the head of household or of his or her spouse. Also starting with the 2013 enumeration, the Census Bureau introduced a requirement that to be counted as a compact migrant, a child or grandchild of a compact migrant must never have been married. For a summary of “compact migrant” definitions used for the enumerations over time, see table 16. The six sets of enumerations of compact migrants that the Census Bureau conducted on behalf of Interior in affected jurisdictions from 1993 through 2018 showed these populations growing in Hawaii and Guam and fluctuating in the CNMI. During our work with the Census Bureau to obtain American Community Survey data related to compact migrant populations, bureau officials discovered a programming error in the 2013 and 2018 enumerations of compact migrants that had resulted in an underestimate of certain compact migrants in Hawaii. The bureau revised these estimates in October 2019 to correct for the error in Hawaii. Figure 9 shows the Census Bureau’s revised estimates of compact migrants in the affected jurisdictions as of October 2019. In February 2020, Interior requested that the Census Bureau further revise its estimates for 2013 and 2018 to no longer count grandchildren. As of March 2020, the results of this revision were not yet available. In the U.S. areas we visited, stakeholders from state and territorial governments, private sector and nonprofit organizations, and freely associated state (FAS) consulates and communities made suggestions for improving experiences or outcomes of compact migration for both the receiving areas and the migrants themselves. Stakeholders recommended that some actions be taken in both the United States after compact migrants’ arrival and in the FASs before the migrants’ departure. Provide more information and education about the compacts. Several stakeholders said that U.S. agencies should better understand the compacts and coordinate their related work. These stakeholders, including members of compact migrant communities, noted that U.S. government officials in some cases have seemed uncertain or unaware that compact migrants are able to live and work in U.S. areas without a visa or other documentation and have asked them to present immigration documents they do not possess or are not required to obtain. An FAS official and community members noted a need for more education of employers and state government officials regarding the migration terms of the compacts and the migration status of FAS citizens in the United States. Restore Medicaid eligibility and expand benefits access. State government officials and health care providers advocated restoring Medicaid access to FAS populations. An FAS Consul General advocated restoring Medicaid eligibility to its pre-1996 status for compact migrants. FAS community members suggested extending Supplemental Nutrition Assistance Program benefits and expanding federal student loan access to compact migrants. Provide more information and guidelines about federal programs and policies. State government officials suggested that changes to federal government policies should include specific information about the applicability of the changes to FAS citizens. Health care providers suggested that the federal government should share more data about compact migration and noted a need for federally established guidelines to support accurate, rather than exaggerated, cost reporting. The providers noted that compact impact estimating was chaotic and had a negative effect on the community. FAS community members expressed interest in federally provided educational sessions and clear eligibility criteria for federal benefits. Simplify Form I-94 access for compact migrants. FAS consular officials and community members said that compact migrants entering the United States should receive information about the importance of their Form I-94 Arrival/Departure Record (Form I-94) and how to retrieve it online. Because compact migrants have had difficulty in accessing these forms, and given the cost of replacing them, FAS community members requested that federal agencies be enabled to retrieve migrants’ Forms I-94 for them. FAS consular officials recommended that compact migrants’ Forms I-94 be made accessible on the Customs and Border Protection website indefinitely, not only for the current 5-year period, since compact migrants’ forms do not expire. Provide more and broader funding to U.S. states and territories. State government officials, nonprofit representatives, and FAS community members said that more federal funding and resources were needed to accommodate the compact migrant population or to support the receiving states and territories. State government officials also said that the federal government should increase compact impact funds to a “reasonable amount,” even if the full costs cannot be covered. They noted that the compacts represent a federal obligation and expressed a belief that the federal government should take care of compact migrants. According to some health care providers, the United States’ treatment of the compact migrant population in U.S. areas could affect the FASs’ compact negotiations with the U.S. government. State government officials also suggested that allowing compact migrants access to more federal benefits would help alleviate compact impact on states and territories. Clarify immigration provisions under the compacts of free association. FAS community members in some locations we visited expressed a need for clarification about the status of migration provisions of the compacts. Specifically, they expressed concern that they might have to leave the United States in 2023. For example, in one FAS community we visited, community members registered confusion about whether provisions of the compacts (including migration provisions) are scheduled to end in 2023 and whether FAS citizens in U.S. areas can become U.S. citizens. One community member expressed concern that compact migrants would be “chased” out of U.S. areas after 2023 and that “all of their rights” under the compacts would be revoked. FAS community members also sought clarification about the implementation of the DHS rule for considering public charge while determining admissibility to U.S. areas. According to community members and other stakeholders, the rule has caused uncertainty in compact migrant communities, which may result in some compact migrants’ not enrolling in, or unenrolling from, public benefits programs. FAS community members said that they are uncertain whether and how the rule change will apply to them and whether enrolling in public benefits or enrolling eligible children will make them ineligible to reenter the United States. FAS consular officials and community members also suggested revising certain immigration provisions—for example, changing compact migrants’ nonimmigrant status to allow them access to a wider range of jobs, including law enforcement and military officer positions. Expand health care access and clinics in U.S. areas. State government officials said they believed that more health education and outreach to FAS communities were needed. A nonprofit representative noted that FAS communities lack vision care and that the extension of postpartum care to FAS communities would improve maternal and child health. FAS community members suggested the creation of a Pacific Islander–specific health clinic in the Pacific Northwest, with translators on staff and on-site enrollment for health insurance. Representatives of a nongovernmental organization in Hawaii that is led and staffed by compact migrants noted that a series of changes in compact migrants’ eligibility for the Hawaii state health care program, Med-QUEST, had caused confusion about compact migrants’ eligibility for public health care benefits. Address preventative care, dialysis needs, and communicable diseases in the FASs. State and territorial government officials and health care providers said that greater access to in-country care, including more resources for primary care, was needed in the FASs. They recommended making more preventative treatment available in the FASs, including diabetes prevention, and establishing clinics in the FASs to potentially reduce the number of individuals moving to the United States for health care. Health care providers suggested that the Department of the Interior (Interior) should produce or fund a study on dialysis in the FASs, including an analysis of whether high-quality dialysis services in the FASs would decrease migration solely for access to dialysis. Territorial government officials suggested that compact migrants should receive health screenings before departing for the United States to identify any serious conditions or communicable diseases. Some health care providers and state government officials proposed that the U.S. federal government focus on reducing or eliminating the transmission of tuberculosis in the FASs. Offer predeparture education to compact migrants in the FASs. State government officials and nonprofit representatives suggested that videos be aired on television in the FASs to support predeparture education, to explain differences they would find in the United States, and to reduce culture shock after arrival. Some state government officials and health care providers suggested that FAS citizens be encouraged to gather documentation, such as immunization and medical records, school records, and anything necessary to obtain a U.S. driver’s license, before departing for the United States. State government officials also suggested that lists of community-based organizations, by U.S. state or territory and city, be provided to FAS citizens before their departure. Offer orientation and information to compact migrants arriving in the United States. State government officials said that U.S. areas should offer and fund location-specific orientations for FAS citizens after arrival. The officials suggested that these orientations should cover how health care eligibility works, what resources are available to compact migrants, and how they can contact interpreters. State government officials also said that proactive education about U.S. laws could help compact migrants avoid behavior or circumstances that might cause them to run afoul of the law, given cultural differences and misunderstandings. Health care providers noted that compact migrants could be given more information to encourage better nutritional choices and more exercise. Expand and professionalize translation and interpretation resources. Compact migrants who are not fluent in English may experience challenges accessing or navigating health care, the judicial system, and educational institutions, according to state government officials, FAS consulate officials, private sector and nonprofit organization representatives, and compact migrant communities. State government officials reported frequent difficulty in finding interpreters and translators for the multiple languages spoken by compact migrants. State government officials recommended that grants be made available to help pay for interpreters until more FAS community members graduate from college and become qualified. The officials also said that interpreters should be encouraged to develop greater proficiency in fields such as law and medicine so that they can serve in multiple capacities. In addition, the officials identified a need for more in-person interpreters in hospitals and medical facilities. State government officials noted that FAS communities speak many different languages, and they acknowledged the need for a culturally-specific approach for each group. They said that, in addition to translating content, interpreters should fully explain the context of programs to ensure compact migrants’ understanding. FAS community members proposed the creation of a group of paid, full-time interpreters and a language certification requirement to guarantee the availability and quality of language services. Create “one-stop shops” with information and resources for compact migrants. State government officials and health care providers identified a need for one-stop shops—centers that serve compact migrant populations—in areas that do not currently have them. According to stakeholders in a U.S. state without such a center, a one-stop shop could reduce duplication and increase coordination among the many groups that serve the FAS community. Other stakeholders suggested that each state government establish a single point of contact for compact migrants. FAS community members and nonprofit representatives identified a need for a cultural center or other physical space that could be used to hold events and provide centralized communication and resources for the FAS community in the Pacific Northwest, in particular. Emphasize community-based approaches to supporting compact migrants. State government officials noted the importance of community- based approaches to supporting compact migrants. For example, stakeholders recommended hiring community health workers from the FAS population to engage with their communities in U.S. areas. According to the officials, community health workers, as known and trusted entities, are better sources of information for FAS communities than any government agency. The officials also acknowledged the importance of engaging with FAS community leaders (including embassy or consular officials and church leaders) in U.S. areas to successfully connect with FAS community members. Provide compact migrant–dedicated housing. State government officials, FAS consulate officials, and nonprofit organization representatives discussed discrimination that compact migrants experienced in housing. For example, stakeholders in some areas we visited described landlords who failed to maintain or repair housing leased to compact migrants, who targeted compact migrants for evictions, or who avoided renting units to compact migrants. Officials in one state suggested that FAS communities need access to dedicated housing options that align with their community traditions and cultural norms, such as units that can accommodate large or multiple families. Nonprofit organizations provide compact migrants with a range of assistance, such as assistance with housing or rent, food, documentation and legal matters, and enrollment in health insurance. Some organizations, such as “one-stop shops” (i.e., centers serving compact migrant populations), serve only compact migrants, while other organizations serve compact migrants among other members of the receiving community. Additionally, some companies that employ compact migrants offer programs intended to help them adjust to life in the United States. The information presented in this appendix is based mainly on documentation provided by the organizations and interviews with their representatives. Several nonprofit organizations in U.S. areas that we visited target their services to compact migrants. Two of these organizations—one-stop shops in Hawaii and Guam—aim to support the compact migrant communities by connecting the migrants to existing resources and, in some cases, creating new programs and services to support freely associated state (FAS) communities, according to nonprofit and government officials and documentation. These one-stop shops receive funding from the U.S. Department of the Interior (Interior) as well as other governmental and nongovernmental sources. In Guam, the Micronesian Resource Center One-Stop Shop was developed with input from various communities in Guam and government agencies and launched in October 2015, according to one-stop shop officials and Interior documentation. The one-stop shop has received an Interior grant each year starting in fiscal year 2016. The amount of the grant has steadily increased, rising from $210,000 in fiscal year 2016 to $217,000 in fiscal year 2017, $250,000 in fiscal year 2018, and $267,000 in fiscal year 2019, according to Interior documentation and officials. The one-stop shop employs both case workers and cultural mediators and uses a mobile van to bring services directly to FAS communities, according to one-stop shop officials. These services include outreach to communities, including youths; workshops for parenting and driving; and assistance with lost or replacement documentation. For example, when conflict escalated among compact migrants living in a Guam apartment complex, Interior and Guam officials noted that the one-stop shop worked with police to facilitate meetings and participation in neighborhood watch programs. The one-stop shop has hosted “Welcome to Guam” orientations to educate compact migrants about finding housing, setting up utilities, and opening a bank account in Guam; employees’ rights; medical insurance; deportable offenses; and the danger of human trafficking, according to one-stop shop officials. In Hawaii, the one-stop shop We Are Oceania was established with Interior funding in 2015. The organization provides case management, helping compact migrants to find jobs, address housing or legal issues, and enroll in health insurance through Hawaii’s Premium Assistance Program, according to one-stop shop officials and documentation. We Are Oceania has also provided cultural consultations and trainings to Hawaii public school teachers and service providers to educate them about cultural differences and potential challenges that compact migrants may face, according to nonprofit representatives and documentation. The officials also said that the organization hosts a youth summit and helped open a newcomer welcome center at a middle school. Figure 10 shows photos of the We Are Oceania facility, including desks where compact migrants can apply for health insurance and other services. Other nonprofit organizations were also founded specifically to assist the compact migrant community in navigating various U.S. systems, such as education and health care, and obtaining documentation such as driver’s licenses or Forms I-94 Arrival/Departure Records. The Arkansas Coalition of Marshallese in Springdale, Arkansas, according to representatives of the organization, helps local compact migrants with tasks such as retrieving new Forms I-94 from Customs and Border Protection; translating state driver’s license applications into Marshallese; providing education about diabetes prevention and management; and enrolling compact migrant children in ARKids, the state’s public health insurance program that extends federal health insurance coverage for children younger than 19 years. In 2018, the Micronesian Islander Community Organization in Oregon announced a study among local compact migrants to identify barriers that they faced in the region, such as a lack of certified health care interpreters. Additionally, the Oregon-based COFA Alliance National Network conducts policy and advocacy work aimed at supporting compact migrant communities, according to representatives of the organization. Charities, legal services, and other programs assist compact migrants and other eligible individuals in selected U.S. areas. For example: In Hawaii, the Salvation Army of the Hawaiian and Pacific Islands provides assistance with rent, utilities, and food; interpreters to assist non–English speakers with accessing health and legal services; and digital literacy training (e.g., how to use email), according to Salvation Army officials. In Guam, the Salvation Army Guam Corps provides assistance with rent, utilities, food, and clothing and also provides case management services, according to Guam officials. In the Commonwealth of the Northern Mariana Islands (CNMI), Karidat provides a food pantry, clothing assistance, rental assistance, and victim advocacy, among other services. (Fig. 11 shows a public bulletin board and donated clothing in Karidat’s offices.) In 2018, compact migrants made up 20.4 percent of individuals accessing Karidat’s food pantry and 39.5 percent of individuals receiving clothing assistance, according to Karidat estimates. The Hawaii and Arkansas chapters of the Legal Aid Society provide legal services to local residents, such as victims of crime, according to Hawaii and Arkansas officials. According to Hawaii chapter officials, they served 569 compact migrants (8.5 percent of their total clients) in fiscal year 2019. The Asian Family Center within Oregon’s Immigrant and Refugee Community Organization provides similar services, including defense for parties engaged in deportation removal proceedings, according to representatives of the organization. Some employers with compact migrant workers provide employee services, programs, or accommodations specific to these workers’ needs. In Arkansas, Tyson, Inc., provides written materials in Marshallese and operates a program that appoints chaplains to help the company’s Marshallese workers, as well as other non–U.S. citizen employees, navigate life in the United States generally and in Arkansas specifically, according to private sector representatives. Additionally, the representatives told us that the company provides free classes in financial literacy and English as a second language to its employees, including compact migrants. Another company in the region, Cargill Protein, has partnered with local nongovernmental organizations to educate its compact migrant employees about U.S. driving laws and help prepare them for driver’s license tests. We examined academic studies published from 2015 through 2019 to determine what is known about the likely effects of migration similar to compact migration on the workforces of receiving countries. Because we were unable to identify articles published during this period that focused specifically on compact migration, we focused our search on studies examining the effects of migration by other groups with relatively few skills. Studies that we reviewed sometimes reached differing conclusions about whether migration is associated with a negative, neutral, or positive effect on the employment and earnings of nonmigrant workers in the receiving countries. Some studies found that migration may result in worsened employment prospects or wages—particularly in the short term and if the influx of migrants is sudden—for nonmigrant workers who are most similar to the migrants in terms of demographics and skills. If the migrant workers are close substitutes for nonmigrants, they may intensify competition for jobs, increasing unemployment and lowering wages for such nonmigrant workers as well as for similar prior migrants. In the case of compact migration, this might include younger and less educated nonmigrants. However, according to other studies and survey papers that we reviewed, nonmigrants, both low and high skill, could benefit as a whole from migration. For example, one study of the effects of migration on 20 countries found that both low- and high-skill nonmigrants clearly benefited from an influx of migrant workers about two-thirds of the time. Nonmigrant workers may benefit from migration if the migrant workers specialize in different skills and vocations than the nonmigrant population, leading to complementary effects from scale and specialization. For example, larger numbers of construction workers may result in greater efficiency and quality in the building of more restaurants and bars, benefitting workers in nonconstruction trades as well as nonmigrant investors and business owners. Institutions may play an important role in determining the effects of migration on the receiving country’s workforce. For example, a study estimating the effect of migrant workers in European Union countries and controlling for institutional and noninstitutional factors showed that the effect of migrants varied between countries, driven in part by differences in their institutional environment, such as the extent of unemployment insurance, fiscal redistribution, and government spending on services and public goods. This study found that, while fiscal redistribution to migrant workers through taxation and unemployment benefits somewhat worsens outcomes for nonmigrants, this effect is often outweighed by the economic contribution of these migrants. Distinctions in statistical methodologies and assumptions may explain studies’ seemingly contradictory conclusions about the effects of migration on the workforce of receiving countries. According to a survey paper reviewing other previously published work, the statistical controls selected for studies of the impact of migration can result in subtle but economically important distinctions in what the studies attempt to measure, such as the total effects of migration on a given region or the effects of migration on a specific group (e.g., a particular education or skill group). According to this and a second survey paper we reviewed, contradictory conclusions may also result from differing assumptions about factors such as the extent to which migrants “downskill” (compete for jobs for which they may be overqualified) and, therefore, about the nonmigrants that should be used as a comparison group to examine the effect of migrants of a particular skill and education level. According to a third survey paper we reviewed, studies also vary in whether they measure the shorter- or longer-term effects of migration; the survey found that negative effects are more often reported when studies measure migration’s shorter-term effects. Academic journal articles that we examined also discuss the potential fiscal effect of migration. Several studies argue that evaluations of migration’s fiscal effect should consider the potential effects over multiple generations and should also consider the indirect fiscal effect of migrants’ influence on native workers. For example, a panel discussion report of the National Academies of Sciences, Engineering, and Medicine states that descendants of immigrants are often studied only as children, in cross- sectional data providing a point-in-time snapshot. As a result, according to the report, the average immigrant household is counted as a net fiscal burden in part because young children of immigrants, like the children of natives, receive public education. The report stated that studying the descendants of immigrants as they complete their education, become workers, and start paying taxes provides a more complete measure of migration’s fiscal effect, because such an analysis may include not only the cost of their education but also the delayed fiscal benefits of that education: larger tax payments made possible by the investment in human capital that education represents. Another paper we reviewed argues that because migrant workers can positively influence the upward mobility of native workers, the higher taxable income from these native workers should be considered, in addition to the low taxable income of the migrants, to avoid negatively biasing the estimated fiscal effect of migrants. The REAL ID Act, passed by Congress in 2005, set minimum document requirements and issuance standards for driver’s licenses and personal identification cards. The act also prohibits federal agencies from accepting for certain purposes driver’s licenses and identification cards from states that do not meet the act’s minimum standards. Citizens of the freely associated states (FAS)—the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau—have always been eligible for REAL ID–compliant driver’s licenses or identification. However, the term of the licenses’ or identification’s validity and the documents that the Department of Homeland Security (DHS) required to establish compact migrants’ identity have varied over time. Currently, compact migrants are eligible for full-term REAL ID–compliant identification. Since September 2019, they have been required to present an unexpired FAS passport and the most recent Form I-94 Arrival/Departure Record (Form I-94) as evidence of identity to obtain the identification. DHS regulations previously required compact migrants to provide documents they were not required to have. Before September 2019, DHS required compact migrants applying for REAL ID–compliant identification to present, in addition to their unexpired foreign passport and Form I-94, either an unexpired U.S. visa (affixed to the passport) or an employment authorization document (EAD). However, under the compacts of free association, compact migrants are not required to obtain a visa or an EAD. On September 4, 2019, DHS modified its policy, designating an unexpired passport from one of the FAS countries, in combination with an individual’s most recent Form I-94, as acceptable evidence of identity that compact migrants may present to obtain REAL ID–compliant identification. Federal law previously restricted the term of the REAL ID–compliant identification that compact migrants could receive. Before December 2018, compact migrants were eligible to receive temporary, limited-term REAL ID–compliant identification, valid until the expiration date on their EAD, which could be a maximum of 5 years, according to DHS officials. In December 2018, the REAL ID Act Modification for Freely Associated States Act made FAS citizens eligible for full-term REAL ID–compliant identification. Since then, compact migrants have been eligible for full- term REAL ID–compliant identification, valid for the maximum number of years for any license or identification as set by individual U.S. states and territories, according to DHS officials. In several areas that we visited, compact migrant communities described challenges they had experienced in obtaining or renewing their REAL ID– compliant identification. Some compact migrants spoke of difficulty due to the requirement to present a visa or an EAD as evidence of identity. In one location, FAS community members said that other members of the community had lost employment on a military base because they were unable to obtain REAL ID–compliant identification. (We heard many of these observations before September 2019, when DHS modified the policy that required applicants for REAL ID–compliant identification to present a visa or EAD.) Some compact migrants reported being unable to obtain REAL ID– compliant identification for other reasons. number on their current foreign passports. When an FAS citizen’s passport expires and he or she renews it while in the United States, the new passport has a different number than the former passport number displayed on the FAS citizen’s Form I-94. 1. Section 104(e)(9)(A) of the amended compacts’ enabling legislation authorized the President of the United States, at the request of the Governor of Guam or the Governor of the Commonwealth of the Northern Mariana Islands (CNMI), to reduce, release, or waive all or part of any amounts owed by the Guam or CNMI government (or either government’s autonomous agencies or instrumentalities), respectively, to any department, agency, independent agency, office, or instrumentality of the United States. According to section 104(e)(9)(B)(iv), that authority expired on February 28, 2005. 2. The Census Bureau data that we report reflect a definition of “compact migrants” that includes citizens of the Federated States of Micronesia (Micronesia), Republic of the Marshall Islands (Marshall Islands), and Republic of Palau (Palau) who entered the United States after 1986 (from Micronesia and the Marshall Islands) or 1994 (from Palau) and their U.S.-born children (biological, adopted, and step-) and grandchildren younger than 18 years. 1. The Arkansas Department of Education’s data estimating the number of compact migrant students at 4,175 is based on students’ ethnicity (Hawaiian and Pacific Islander) in the 2018-2019 school year. As a result, Arkansas’s estimate may include students who are not Marshallese. In addition, Arkansas’s estimate may include second- generation U.S. citizens, including Marshallese children born in the United States to Marshallese parents who were also born in the United States. The American Community Survey data that we report reflect a definition of “compact migrants” that includes only citizens of the Federated States of Micronesia (Micronesia), Republic of the Marshall Islands (Marshall Islands), and Republic of Palau (Palau) who entered the United States after 1986 (from Micronesia and the Marshall Islands) or 1994 (from Palau) and their U.S.-born children (biological, adopted, and step-) and grandchildren younger than 18 years. The 5,895 compact migrants that the Census Bureau estimated resided in Arkansas during the period 2013 to 2017 (a different time period from that of the data cited by the government of Arkansas) includes only adults and children who met those criteria. We believe that the Census Bureau data are sufficiently reliable for our purposes of estimating the number of compact migrants in U.S. areas. However, our report includes a discussion of stakeholder concerns that the compact migrant population in Arkansas may be undercounted. 2. The population estimate cited in the published study from Arkansas is based in part on a 2013 statement by a Marshallese consulate official. The Arkansas Department of Education estimated there were 4,175 Hawaiian and Pacific Islander students in Arkansas schools in the 2018-2019 school year. 3. Costs related to compact migration in U.S. areas not considered affected jurisdictions are outside the scope of our review. 4. We updated our report to reflect the data that the government of Arkansas cites for the period 1997 to 2019. 1. We have previously reported on defense issues in the Federated States of Micronesia and the Republic of the Marshall Islands (Marshall Islands). For more information about the United States’ right to use part of the Kwajalein Atoll in the Marshall Islands for missile tests and space tracking operations, see GAO, Foreign Relations: Kwajalein Atoll Is the Key U.S. Defense Interest in Two Micronesian Nations, GAO-02-119 (Washington, D.C.: Jan. 22, 2002). For more information about the Marshall Islands’ Nuclear Claims Trust Fund, see GAO, Marshall Islands: Status of the Nuclear Claims Trust Fund, GAO/NSIAD-92-229 (Washington, D.C.: Sept. 25, 1992). 2. Our report provides some information about contributions by compact migrants, including qualitative statements about their budgetary, workforce, and community contributions as well as high-level data on their average per-capita income (see app. IV). We have added the government of Oregon’s statements about the contributions of compact migrants to our report. 3. As our report notes, the affected jurisdictions are defined in the amended compacts’ implementing legislation, which also establishes funding for the associated compact impact grants for those jurisdictions. 4. We made revisions in our report to help direct readers to stakeholders’ suggestions for improving experiences or outcomes of compact migration, presented in appendix VII. 1. Our report incorporates the results of our interviews with members of compact migrant communities, including their reasons for migrating to U.S. areas, workforce challenges and other challenges they face, and their contributions to U.S. communities. Our report also includes these and other stakeholders’ suggestions for improving experiences or outcomes of compact migration (see app. VII). 2. We have previously reported on defense issues in the Federated States of Micronesia and the Republic of the Marshall Islands (Marshall Islands). For more information about the United States’ right to use part of the Kwajalein Atoll in the Marshall Islands for missile tests and space tracking operations, see GAO, Foreign Relations: Kwajalein Atoll Is the Key U.S. Defense Interest in Two Micronesian Nations, GAO-02-119 (Washington, D.C.: Jan. 22, 2002). For more information about the Marshall Islands’ Nuclear Claims Trust Fund, see GAO, Marshall Islands: Status of the Nuclear Claims Trust Fund, GAO/NSIAD-92-229 (Washington, D.C.: Sept. 25, 1992). (from Micronesia and the Marshall Islands) or 1994 (from Palau) and their U.S.-born children (biological, adopted, and step-) and grandchildren younger than 18 years. Given this definition, any individual older than 18 years who was not born in an FAS would not be counted as a compact migrant in the Census Bureau enumerations or the American Community Survey data in this report. 8. Table 10 in appendix II of our report includes estimates of the number of compact migrants in states with fewer than 1,000 estimated compact migrants, except when the data were suppressed by the Census Bureau or the number was unreportable because the margin of error exceeded the estimate. 9. Our report notes that some FAS citizens move to U.S. areas to join the military and that the FASs have a high rate of U.S. military service, according to FAS officials and Department of State documentation. 10. The amended compacts’ implementing legislation permitted the affected jurisdictions (Hawaii, Guam, the Commonwealth of the Northern Mariana Islands, and American Samoa) to submit compact impact reports to the Secretary of the Interior. The definition of “affected jurisdictions” in the legislation did not include any mainland states. 11. Our report notes that compact migrants work in professional industries, including jobs in government and education. 12. We updated our report to include information about the locations of COFA Alliance National Network chapters in states other than Oregon. 1. Our report describes policies allowing compact migrants to access in- state tuition at colleges and universities in some U.S. areas but does not include a comprehensive description of such policies in all U.S. areas. 2. Our report describes this and other challenges related to Form I-94 and includes freely associated state consular officials’ recommendations to their citizens experiencing this challenge (see app. VII). Pacific in the 2005 legislation was an error, it had no impact on FAS citizens’ eligibility for limited-term REAL ID–compliant identification. David Gootnick, (202) 512-3149 or gootnickd@gao.gov In addition to the contact named above, Emil Friberg (Assistant Director), Caitlin Mitchell (Analyst-in-Charge), Topher Hoffmann, Andrew Kurtzman, Reid Lowe, Moon Parks, and Nicole Willems made key contributions to this report. Kathryn Bernet, Justin Fisher, Rebecca Gambler, Christopher Keblitis, Ty Mitchell, Mary Moutsos, and Michael Simon provided technical assistance.

Summary: The U.S. compacts of free association permit eligible citizens from the freely associated states (FAS), including Micronesia, the Marshall Islands, and Palau, to migrate to the United States and its territories without visa and labor certification requirements. In fiscal year 2004, Congress authorized and appropriated $30 million annually for 20 years to help defray costs associated with compact migration in affected jurisdictions, particularly Hawaii, Guam, and the CNMI. This funding ends in 2023, though migration to U.S. areas is permitted to continue and is expected to grow. GAO was asked to review topics related to compact migration. This report describes (1) estimated compact migrant populations and recent trends in compact migration; (2) reported costs related to compact migration in Hawaii, Guam, and the CNMI; and (3) effects of compact migration on governments, workforces, and societies in these and other U.S. areas. GAO reviewed Census Bureau data to determine the numbers of compact migrants in U.S. areas. In addition, GAO interviewed federal, state, and territory government officials; representatives of private sector and nonprofit groups employing or serving compact migrants; FAS embassy and consular officials; and members of compact migrant communities. In commenting on a draft of this report, U.S. area governments and FAS Ambassadors to the United States identified areas for additional study related to compact migration and impact. Some also discussed policy considerations, including restoration of Medicaid benefits to compact migrants. More than 94,000 compact migrants—that is, citizens of the Federated States of Micronesia (Micronesia), the Republic of the Marshall Islands (Marshall Islands), and the Republic of Palau (Palau) as well as their U.S.-born children and grandchildren younger than 18 years—live and work in the United States and its territories, according to Census Bureau data. Data from Census Bureau surveys covering the periods 2005-2009 and 2013-2017 and an enumeration in 2018 show that the combined compact migrant populations in U.S. areas grew by an estimated 68 percent, from about 56,000 to about 94,000. Historically, many compact migrants have lived in Hawaii, Guam, and the Commonwealth of the Northern Mariana Islands (CNMI). From 2013 to 2018, an estimated 50 percent of compact migrants lived on the U.S. mainland. Hawaii, Guam, and the CNMI track and report the financial costs related to compact migration, or compact impact, for their state or territory. These areas reported estimated costs totaling $3.2 billion during the period fiscal years 2004 through 2018. In fiscal years 2004 through 2019, Hawaii, Guam, and the CNMI received a combined total of approximately $509 million in federal grants to help defray the costs of providing services to compact migrants. In the U.S. areas GAO visited—Arkansas, the CNMI, Guam, Hawaii, Oregon, and Washington—state and territorial officials identified effects of providing public education and health care services to compact migrants. Some area governments use a combination of federal and state or territorial funds to extend health care coverage to compact migrants. For example, some states help compact migrants pay for coverage through health insurance exchanges, created under the 2010 Patient Protection and Affordable Care Act, by covering the cost of premiums not covered by advanced premium tax credits available to eligible compact migrants. Effects of compact migration in these U.S. areas also include compact migrants' budgetary contributions through payment of taxes and fees as well as their workforce contributions—for example, through jobs in hotels, manufacturing, the U.S. military, poultry processing, caregiving, and government.