Hospital patients in American Samoa needing off island medical care, will all have to pay their own expenses because the LBJ Medical Center has no money for the service.
LBJ's chief executive officer, Mike Gerstenberger, says due to financial constraints, no funding allocation was made for the programme this fiscal year but the hospital still provides referral information for patients needing off-island care.
He says the only benefit at this point are the discount airfares to Honolulu provided by Hawaiian Airlines under an agreement with the hospital.
In order for the programme to be fully funded and operational Mr Gerstenberger says about six million US dollars is needed each year.
Last year just 1 point 5 million dollars was provided.
This paid for 11 patients with another 80 paying their own way.