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Washington Public Assistance for Persons from the Marshall Islands, Micronesia, and Palau

Authored By: Northwest Justice Project LSC Funded

This is for citizens of the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau. Some call these individuals Compact of Free Association (“COFA”) migrants, because they are related to the U.S. through Compact of Free Association treaties. #7938EN


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Should I read this? 

This publication talks about public benefits available to citizens of the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau.  People from these countries are allowed to enter the U.S. under the Compact of Free Association. They are sometimes called “COFA islanders” or “COFA migrants.”

*This is general info only. For advice about your situation, talk with a lawyer.

What rights do I have in the U.S. as a COFA migrant?

You have the right to live and work indefinitely in the U.S. 

Am I eligible for any public benefit programs?

As a COFA migrant, you may be eligible for these cash, food, and medical assistance programs if you also meet other program requirements, such as having a low income:

Medical Assistance:

  • Qualified Health Plans (health insurance) purchased through Healthplanfinder, the state health insurance exchange, and tax credit and subsidies to help with out-of-pocket costs

  • The COFA Islander Health Care Program. This program helps with premiums and other costs for Qualified Health Plans purchased through Healthplanfinder – see below

  • Emergency Medicaid for treatment of emergency conditions in a hospital setting

  • Cancer treatment and dialysis, including a limited state-funded program for people needing long-term care

  • Medical Care Services (MCS) medical assistance if you are over 65 or have a disability

  • Children’s and pregnant women’s medical assistance

  • immunizations, testing, and treatment of communicable diseases

Cash Assistance:

  • State Family Assistance for families with dependent children

  • Aged Blind and Disabled (ABD) if you are over 65 or have a disability – read Help for People Unable to Work: ABD and HEN

  • Pregnant Women’s Assistance

Food Assistance:

  • The state-funded Food Assistance Program

  • School lunch and child nutrition programs

  • Supplemental nutrition program for Women, Infants, and Children (“WIC”)


  • Working Connections subsidized child care – read Working Connections Child Care

  • Disaster relief - help after a natural disaster, like an earthquake

  • Foster care and adoption assistance

  • Higher education loans, Head Start and other education programs

  • Job Training Partnership Act assistance - help training for jobs

  • Community programs to protect life or safety such as domestic violence shelters

  • Consolidated Emergency Assistance Program (CEAP) - limited assistance with emergency needs for people ineligible for other programs. Read CEAP: Extra Money for Needy Families

What is the COFA Islander Health Care Program?

It is a special program in Washington State. It helps eligible COFA Islanders afford health coverage. 

Starting January 1, 2019, the state of Washington will pay monthly premiums and out-of-pocket expenses for COFA migrants who meet other requirements and who buy health coverage through the state health care exchange (“Healthplanfinder”).  You cannot be getting other federal or state medical coverage.  You also must:

  • Have income of less than 133% of the federal poverty level - $2,782/month for a family of four

  • Live in Washington state

  • Enroll in a “silver level” qualified health plan

  • Agree to file federal taxes, even if you do not meet tax filing requirements

*Starting January 1, 2020, this program will also provide dental care.

Visit the Health Care Authority website for more info, including videos available in several languages.

When should I apply for the COFA Islander Health Care Program?

You must submit an application for coverage during open enrollment, November 1, 2019 through December 15, 2019, for coverage starting January 1, 2020. 

If you do not apply during the enrollment period, you may be eligible to enroll during a special enrollment period if you have had a life change, such as losing other medical coverage or having a change in your household size, or a special circumstance applies, such as being a victim of domestic violence.

How do I apply for the COFA Islander Health Care Program?

You can apply

You can also e-mail cofaquestions@hca.wa.gov for more info about how to apply. 

Am I eligible for Medicaid?

As a COFA migrant, you are only eligible for emergency Medicaid. This covers treatment of emergency conditions in a hospital setting.  Advocacy groups and lawmakers are hoping to change the law in the future to restore non-emergency Medicaid eligibility to COFA migrants.

Will I need proof that I am a COFA migrant when I apply for benefits?

Yes. You must have proof that you are a citizen of the Republic of the Marshall Islands, the Federated States of Micronesia, or the Republic of Palau. The best proof is your passport. 

If you do not have documents showing your status, talk with an immigration lawyer. Try contacting the Northwest Immigrant Rights Project:

  • in Western Washington - 800-445-5771

  • If you live in Asotin, Benton, Columbia, Franklin, Garfield, Kittitas, Klickitat, Walla Walla Whitman & Yakima counties - 888-756-3641 

  • If you live in Adams, Chelan, Douglas, Ferry, Grant, Lincoln, Okanogan, Pend Oreille, Spokane & Stevens counties - 866-271-2084

I do not speak English. I need to apply for benefits. What should I do?

You should indicate on the application form

  • that you have a hard time reading, writing, speaking or understanding English 

  • the language in which you prefer to communicate 

DSHS must give you a free interpreter and translated notices about your benefits so you can read about your rights and responsibilities in your own language.  HCA and HBE must also provide free interpreter services and translated notices. 

Keep a copy of any notices you get about your benefits.  If you do not understand something in a notice, contact the office that sent it.  Ask for help.  

  • DSHS: contact your caseworker, local community services office, or the customer service center at 1-877-501-2233. 

  • HBE: call the Customer Support Center at 1-855-923-4633. 

  • HCA: call Medical Eligibility Determination Services at 1-855-623-9357. 

Each of these offices should give you a translated notice or telephonic interpretation of the notice so you can fully understand what it says. 

You should also keep a copy of any info you give to DSHS, HCA or HBE, and proof of mailing or that you submitted it in person. Ask to have a copy date-stamped when you file it.  Having copies of your correspondence to and from DSHS and HCA and HBE may help if there are problems with your benefits. 

What if my benefits application is denied?

If DSHS, HBE or HCA denies your application and you believe you are eligible, or you want someone else to review your case, you can appeal.  If you disagree with a decision by DSHS, tell your worker you want an Administrative Hearing or ask for a Hearing Request form to fill out.  If you disagree with a decision by HBE or HCA, they should give you a copy of an appeal form to submit.  If they do not, call 1-855-923-4633 (HBE) or 1-855-623-9357 (HCA) to ask for one. 

You should appeal quickly. Deadlines for filing an appeal are short.  Contact a legal services office for advice.  Read Representing Yourself at an Administrative Hearing.

There is no fee or penalty for requesting an administrative hearing with DSHS, HBE or HCA.  You can withdraw (take back) your request later if you find out the decision was correct. 


This publication provides general information concerning your rights and responsibilities. It is not intended as a substitute for specific legal advice.

This information is current as of October 2019.

© 2019 Northwest Justice Project — 1-888-201-1014.
(Permission for copying and distribution granted to the Alliance for Equal Justice and to individuals for non-commercial purposes only.)


Last Review and Update: Oct 18, 2019