Guam - Although a highly informative Guam Medical Association forum was held last week discussing the affects of Obama Care on Guam, several unanswered questions need to be address before determining the next steps with the Patient Affordable Care Act.

According to committee on Health Chair Senator Dennis Rodriguez, Jr., one of the biggest issues raised relates to a million-dollar grant GovGuam has received to assess how to establish and run a health insurance exchange but has yet to utilize. "The consequences are greater that if we don't figure out how we're going to establish our own exchange here the federal government may establish this exchange," he said.

Rev & Tax director John Camacho meanwhile says GovGuam has held-off on using the grant because should it decide otherwise to not establish the exchange, it would have to repay the grant.

And while the U.S. Territories would receive about $75 million for Medicare funding should they opt out of the exchange, he is concerned about how GovGuam would fund certain subsidies. "If we basically establish the exchange in 2014, then there's going to be some subsidy that will happen with the government and that subsidy that they were talking about earlier is about $70 to $74 million, that our office estimates in the low-income housing," he said.

Rodriguez meanwhile is waiting for legal review and guidance from the Attorney General's Office on how the law applies to Guam.