Marshall Islands Foreign Minister Kalani Kaneko has been leading advocacy for island US military veterans. He is pictured here in January with, from left: Australian Ambassador Paul Wilson, former US Ambassador Laura Stone, Kaneko, and Japan Ambassador Hirohisa Soma
Photo: Giff Johnson
Securing essential healthcare services for US military veterans from three North Pacific nations remains a persistent challenge.
Despite the US Congress specifically authorising in-country services by the US Veterans Administration for veterans of the Marshall Islands, the Federated States of Micronesia (FSM), and Palau, the Trump administration over a year ago suspended ongoing talks to implement services.
All three island nations have been lobbying for years to get action for their hundreds of military veterans who, unlike American veterans, do not have easy – or any – access to Veterans Administration services – unless they move to the United States.
Marshall Islands Foreign Minister Kalani Kaneko, himself a US Army veteran, has been at the forefront of pushing US authorities to begin implementing healthcare for island veterans.
“Most importantly, the Compact legislation approved by the United States Congress specifically mandates the provision of VA services to the Freely Associated States,” he said in an interview this week.
“This was not intended to be a symbolic commitment, but a practical obligation reflecting the unique relationship between our nations,” Kaneko said.
Islanders from the three Freely Associated States (FAS) are allowed by the treaties with the US to enlist in the US Armed Forces and do so at per capita rates generally higher than those of Americans.
“Marshallese citizens have served honorably in the United States Armed Forces for generations, often at one of the highest per-capita rates of military service in the world,” Kaneko said.
“The United States military continues to recruit in the Marshall Islands, and with that recruitment comes a shared responsibility to ensure veterans can access the care and benefits they earned through their service.”
Kaneko said the discussions that the Veterans Administration halted over a year ago have not yet started.
“Formal discussions have not fully resumed, and we have not yet received a definitive timeline from the US government regarding next steps,” he said. But, he added, the government is continuing to advocate for its veterans “to ensure this issue remains a priority.”
In comments issued last month to the US Government Accountability Office, FSM’s ambassador to the US Jackson Soram said based on the US Congress-approved Compact legislation, the “Freely Associated States had been in dialogue with the Veterans Administration on increased access to healthcare for FAS veterans.”
“In April 2025, after negotiations were underway, the Department of Veterans Affairs unexpectedly suspended the discussions that had been authorised by the US Congress.”
Soram said all three FAS governments want to resume discussions on this. “This is a fundamentally important goal of the FAS,” Soram added.
Kaneko confirms this sentiment.
“The RMI continues to engage the United States government regarding the implementation of VA services under the 2023 Amended Compact,” Kaneko said.
“Late March this year, Senator Wilbur Heine and I led an RMI delegation to Washington, DC to meet directly with officials from the Veterans Health Administration (VHA) and other relevant US agencies to address this issue and several other Compact implementation concerns affecting our people.
“During those discussions, we expressed our serious concerns regarding the continued delay in delivering VA services to veterans residing in the Republic of the Marshall Islands.
“The VHA proposed that eligible veterans in the RMI utilize the VA Foreign Medical Program, which allows veterans living abroad to access reimbursement for certain covered medical care received in foreign countries.
“However, we made clear that this approach does not adequately address the realities on the ground in the Marshall Islands.”
Kaneko emphasised the point that the RMI’s healthcare system “lacks many of the specialised services, medical expertise, and support systems required to meet the unique needs of veterans, particularly those with service-related conditions.
“If these services already existed locally, our veterans would not be forced to travel abroad or continue facing significant barriers to care.”
Kaneko said the Marshall Islands “remains firm in its position that veterans residing in the RMI deserve meaningful and accessible VA services consistent with both the letter and spirit of the Compact.
Kaneko was a recruiter for the US Army for much of his time in the military and expresses a feeling of personal responsibility about the provision of healthcare services.
“As a retired US Army soldier who personally recruited many Marshallese men and women into military service, this issue is deeply personal to me,” he said.
“Our government will not sit idle while our veterans continue to face barriers to the benefits they were promised and earned through sacrifice and service.
“This is not simply a policy matter; it is a matter of trust, fairness, and honoring the enduring partnership between the Republic of the Marshall Islands and the United States.”
