American Samoa's Medicaid director says she's suspended critical health services in the territory because of a dire lack of funding.
Sandra King Young told a US Congressional Panel that American Samoa doesn't have the funding to match the federal Medicaid programme.
She says that without a grant increase or matching requirement relief, which is in several pending bills, she must continue to make life and death decisions.
Ms King Young gave the example of a decision about whether to send a 6-month old suffering from severe cerebral palsy to New Zealand for treatment.
"Our government only provided two million dollars in local match to do the off island referral," she said.
"We made the difficult decision to deny the referral of this child because we didn't have the local match. A few weeks later the infant died."
Sandra King Young said the fact the territory does not get the same level of medicaid funding as a US state is unconscionable.