With the Medicaid funding-cliff deadline quickly approaching for Puerto Rico and the U.S. Virgin Islands (USVI), the U.S. House easily passed a bill on Sept. 19 that would temporarily delay the looming crisis for the two territories.
The measure is now before the U.S. Senate, which is expected to vote on the initiative before the Sept. 30 deadline.
The measure passed the U.S. House by a vote of 301 to 103, according to Politico.
The bill provides temporary funding for the federal government until just before Thanksgiving. U.S. lawmakers must then reach another accord, either another temporary funding patch until Christmas or for the entire fiscal year, Politico reported.
The House version of the bill provides a temporary extension of Federal Medicaid Assistance Percentage (FMAP) benefits to Puerto Rico, the USVI and other “insular territories” ahead of the Sept. 30 expiration of those benefits.
If passed and signed into law, the Continuing Resolution will extend the temporary 100 percent FMAP to Puerto Rico and USVI to Nov. 21, giving the U.S. Congress an additional eight weeks to work on a long-term solution.
Unlike in the states, where FMAP is not capped and the federal share varies based on the per capita income of residents of that state, federal funding for Medicaid in the territories is subject to a statutory cap and a fixed federal matching rate. As a result, the FMAP to Puerto Rico and the USVI is capped at 55 percent, resulting in a chronic underfunding of the program, according to local government officials.
An estimated 1.6 million Puerto Rico residents are Medicaid beneficiaries and, without the additional federal funds, the island’s Medicaid funding shortfall for fiscal year 2020 is estimated at over $1 billion—hence, the Medicaid funding cliff.
A report by the Government Accountability Office concluded that the federal share for FMAP in the U.S. territories would be 83 percent if the formula was calculated in the same way that it is for the 50 states. If the FMAP rates for the U.S. territories were calculated based on per capita income in the same way, each of the territories would have an FMAP rate in the 70 percent to 80 percent range, according to data from insurance company Assured Guaranty.
“The Section 1108 federal dollar cap is reset every year, with a $359.2 million cap in Fiscal Year 2018 [for the island], which covers only about 13 percent of Puerto Rico’s Medicaid costs,” Assured Guaranty said.
Gov. Wanda Vázquez said she was optimistic that the temporary stopgap measure would soon be approved. “The efforts that we made in the Federal Capital, along with the Secretary of Health, Rafael Rodríguez, other agency heads and Resident Commissioner Jenniffer González, have paid off, given that during our [recent visit to Washington, D.C.,] we were able to restore communications and trust of the [federal] government. I hope that this resolution will be approved in due time,” the governor said.
The stopgap measure also provides time for Puerto Rico to continue its lobbying efforts to gain parity in FMAP funds. “This will allow time to continue our efforts to get a four-year assignment for the Medicaid program for Puerto Rico, for the benefit of thousands of Puerto Ricans,” the Health chief said.