Alia El-Assar

Hispanic Federation Applauds Bipartisan Legislation to Temporarily Extend Medicaid Funding to Puerto Rico and U.S. Territories

Urges Congress and the Biden administration to take action on permanent solutions to ensure federal benefits parity for Puerto Rico

WASHINGTON - Hispanic Federation applauds the new bipartisan agreement to extend increased federal funding and Federal Medical Assistance Percentages (FMAP) levels for another five years for Puerto Rico and eight years for other U.S. territories. The agreement, announced last week by Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ) and Republican Leader Cathy McMorris Rodgers (R-WA), is scheduled to be introduced by Reps. Darren Soto (D-FL) and Gus Bilirakis (R-FL) for markup in the Health Subcommittee today, Thursday, July 15.

The announcement comes as the Medicaid funding ‘cliff’ for U.S. territories looms ahead, with the latest temporary boost in federal funding implemented during the COVID-19 pandemic set to expire on Sep. 30. Without additional funding, this would leave nearly fifty percent of Puerto Ricans living on the island without access to healthcare on par with Medicaid recipients in the U.S. states. Although Puerto Rico has a poverty rate more than two times that of the U.S.’ poorest state, Mississippi, and an estimated 1.4 million U.S. citizens in Puerto Rico live below the poverty line, the island continues to have unequal access to Medicaid and other federal benefits. Unlike the 50 U.S. states and DC, U.S. territories depend on a fixed Medicaid “block grant” spending cap determined by Congress which is unrelated to the actual need on the ground. Puerto Rico’s capped federal allocation covered only 15 percent of the island’s average annual Medicaid costs between 2012 and 2019. In FY 2020, Puerto Rico’s federal Medicaid allocation was capped at $375.1 million, despite having projected Medicaid expenditures of $2.8 billion. As a result of this historic lack of Medicaid parity, Puerto Rico cannot afford to provide seven of Medicaid’s 17 mandatory services, including nursing home care and nurse practitioner services.

If federal funding is not boosted, the cliff could result in devastating cuts in Medicaid benefits to more than one million American families living in Puerto Rico, including many who became eligible for the program as a result of the COVID-19 pandemic and economic downturn.

“Hispanic Federation welcomes the introduction of the Supporting Medicaid in the U.S. Territories Act (H.R. 4406), a crucial piece of legislation that will ensure low-income Puerto Ricans continue to receive the basic human right of accessible health care. However, this only demonstrates the need to permanently dismantle discriminatory policies that prevent parity and treat Puerto Ricans on the island and U.S. citizens residing in territories as second-class citizens,” said Laura M. Esquivel, vice president of federal policy and advocacy at Hispanic Federation. “Without more federal funding and a permanent, equitable expansion of Medicaid to all of the territories, nearly two million Americans living in Puerto Rico and the other U.S. territories will see their access to medical care severely curtailed, while others who only qualified under the recent expansion may lose access altogether – including over half of enrollees in Guam and the Virgin Islands. All U.S. citizens should receive equitable treatment regardless of where on U.S. soil they are born or choose to reside. We urge Congress to provide permanent solutions and equitable access to federal funding by passing the Insular Area Medicaid Parity Act (H.R. 265), and the Territorial Equity Act of 2021 (H.R. 2713). An important parallel step in this effort would be for the Biden Administration to terminate the Trump-era appeals of court decisions that found denying Puerto Ricans many of these benefits is discriminatory.”