Overview:
More Palau patients could receive free medical treatment in Hawaii after Tripler Army Medical Center removed its cap on patients from Micronesia, potentially reducing Palau's nearly $4 million annual overseas medical referral costs.
By L.N. Reklai
KOROR, Palau (Nov. 5, 2026) — More Palau patients may soon receive medical treatment at Tripler Army Medical Center in Hawaii at no cost, following a policy change that removes the limit on the number of patients the hospital can accept from Micronesia.
President Surangel Whipps Jr. announced the change during a presidential press conference Tuesday, Nov. 3, saying Tripler previously accepted no more than 100 patients annually from across Micronesia. Under the new policy, the medical center can accept as many qualified patients as its doctors refer.
Whipps described the change as good news for Palau, which has been sending patients overseas for specialized medical treatment.
He said Tripler has already accepted 26 patients from Palau this year. He also reported that Tripler doctors reviewed Palau’s overseas medical referral cases from last year and determined that as many as 92% could have qualified for treatment at the Hawaii facility.
Tripler Army Medical Center provides treatment at no cost to eligible patients, including round-trip airfare between Palau and Hawaii. Patients must first be referred by a Tripler doctor to qualify for the services.
Whipps said the expanded access could significantly reduce the financial burden on the Palau HealthCare Fund.
Palau HCF spends nearly $4 million annually on overseas medical referrals to Taiwan, the Philippines and India.
Whipps also said the policy change creates an opportunity to make better use of Palau’s investment in medical housing in Hawaii.
The Palau government purchased a house in Honolulu for $3.6 million to accommodate patients traveling to Hawaii for medical treatment. Whipps said the government had considered selling an older Palau-owned house in Hawaii but may instead renovate it to accommodate more patients.
The older house can accommodate up to 20 people, he said.
The Palau HealthCare Fund, however, anticipates higher operating costs as it prepares for an increase in patients referred to Tripler and the management of the newly acquired medical housing facility.
The anticipated expenses include additional personnel and a vehicle to support patient transportation and services in Hawaii.
The fund estimates that these additional responsibilities could increase its costs by 55%, or approximately $344,478.
Despite the expected increase in operating expenses, the expanded access to Tripler could help Palau reduce the amount it spends on overseas medical referrals, particularly if more patients who would otherwise be sent to Taiwan, the Philippines or India can receive treatment in Hawaii at no cost.
The policy change is expected to provide more treatment options for Palau patients while potentially easing the financial demands on the country’s HealthCare Fund.