Guam - As of January 1, individuals and small businesses with less than 50 employees are eligible to apply for health insurance under Obamacare on Guam but the cost will be extremely high.  Insurance commissioner Art Ilagan says the territory must comply with the mandates of the Patient Protection and Affordable Care Act as it is treated like the rest of the states but without a subsidy for implementation, it makes getting an individual policy nearly impossible.

"The problem with Obamacare is in the statute it states that territories are not a state but also amends the Public Health Service Act that states and the territories," he said. "IIt's a state so what that means is the benefits apply."

PPACA requires health insurers in the territories to accept all individuals no matter how sick, but it doesn't mandate that all residents buy the plans and it doesn't provide any subsidies to make coverage more affordable.  The concerns have been brought to the attention of the U.S. Department of Health and Human Services as Ilagan says the continued mandate for insurance companies to provide essential benefits outlined in Obamacare could drive the companies out of doing business on Guam.  Those benefits include ambulatory patient and emergency services, hospitalization, maternity and newborn care as well as prescription drugs, laboratory services and pediatric services.

Ilagan meanwhile says he is still waiting for a response from the federal government addressing Guam's concerns with Obamacare.