As I noted way back in October (seriously, I made a note of it at the bottom of the spreadsheet the very first week), the ACA situation in Guam, American Samoa, Puerto Rico, the U.S. Virgin Islands and the Northern Mariana Islands is, to put it mildly, kind of screwed up. Due to some massive oversights, they were stuck with some of the ACA's provisions (no denials for pre-existing conditions, having to accept everyone, etc.), but didn't get the other key provisions (no exchanges, no subsidies). As a result, it's been a bit of a mess.
Thankfully, the problem has been "solved", although not quite the way the Obama administration intended:
Guam and the four other American territories got some good news this week: they will no longer be held hostage by a byzantine set of Obamacare rules and regulations.