Health Insurance

With Puerto Rico continually petitioning for more Medicaid funds, House Speaker Rafael Hernández affirmed that the legislative body will continue its efforts to achieve fund parity for the island to stabilize its health system.

“It is time to act, and we are optimistic that we can work together with Congress to fulfill the proposal of the administration of U.S. President Joe Biden, that we have full access to Medicaid on the island. Our health system needs a permanent solution to stabilize it,” he stated. On May 28, Biden formally requested Congress to provide Medicaid fund parity for Puerto Rico and to streamline equal access to the Supplemental Security Income (SSI) and food assistance.

Hernández announced that he will ask Biden “to do his good work and follow up on his initiative in the federal Congress. We also formally request Gov. Pedro Pierluisi not to give in to the fairness claim, and we make ourselves available to work together in this feat. These initiatives are [nonpartisan] and impact all socioeconomic sectors on our island. Therefore, we are all called to join forces and work as a team.”

He added that the Democratic Party has enough votes in Congress to approve the necessary language in the resolution for the federal budget, “and we need to take advantage of that juncture.”

The House Speaker explained that some of the programs that Puerto Rico is not part of, and could be accessed, are hospice services, improved pay for health professionals, and an increased number of people who qualify for the Medicaid program, among others.

“It is imperative to recognize the gigantic impact of receiving 83 percent Medicaid coverage for the central government’s budget. For example, the budget approved last June in the legislative assembly, and signed by the governor, contemplates a contribution for the Vital [health insurance] plan of $1,555,721,000 from the General Fund and $557,535,000 from federal funds, while in the previous budget that ended in June, only $316,134,000 were spent from the General Fund, with a federal contribution of $2,842,337,000,” he underscored.

Moreover, he stressed that the local government could save over $1 billion annually if Congress approves parity in Medicaid funding for Puerto Rico. According to Hernández, this measure would provide “stability and certainty” to the public healthcare system, thus “cementing the departure of the [Financial Oversight and Management] Board, together with a good restructuring of central government debts.”

This week, Hernández is in Washington, D.C., carrying out lobbying efforts in Congress and the White House with aims to achieve more resources for Puerto Rico.

Extended Benefits

Meanwhile, the Health Subcommittee of the U.S. House Committee on Energy and Commerce evaluated and approved last week H.R. 4406, “Supporting Medicaid in the U.S. Territories Act,” which would prevent Medicaid funds for the island from running out at the end of this fiscal year in September.

During the markup, U.S. Rep. Cathy McMorris Rogers - the Republican leader in the committee - acknowledged the efforts of Resident Commissioner Jenniffer González to ensure that Medicaid beneficiaries in Puerto Rico do not lose access to that health benefit.

The resident commissioner has been advocating and working in a bipartisan manner to achieve this agreement that will extend the increase in funds and levels of the Federal Medical Assistance Percentage (FMAP) for five years for Puerto Rico to the current levels of 76 percent, providing stability to the health system. The annual limit is increased from $390 million to more than $2.7 billion until fiscal year 2026. In other words, the cap that was established for 2021 is maintained.

H.R. 4406 was authored by Florida Reps. Darren Soto (D-FL-9) and Gus Bilirakis (R-FL-12). The measure continues to advance in the legislative process and this week it will be fully reviewed by the U.S. Energy and Commerce Committee.

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