Velazquez Bill Seeks Medicaid Parity for Puerto Rico

Washington, D.C.­­ – Today, Rep. Nydia M. Velázquez (D-NY) introduced the "Puerto Rico Health Care Fairness, Accountability, and Beneficiary Access Act of 2019," legislation that would put Puerto Rico's Medicaid program on a path to parity with other Medicaid programs throughout the United States.

"Puerto Rico faces a healthcare crisis, due in large part to disparate treatment under Medicaid," said Velázquez. "Although the Island is one of the poorest parts of the United States, it receives significantly less in matching federal funds for every dollar Puerto Rico spends on Medicaid, compared to state Medicaid programs. As a result, the Island is running out of money to meet these U.S. citizens' health needs and medical professionals are flocking from the Island to the mainland. This bill would address the immediate shortfall and, at last, provide a path for Puerto Rico to receive the same treatment as states' Medicaid programs."

While states receive federal reimbursement under the Federal Matching Assistance Program (FMAP) based on their average per capita income, Puerto Rico receives a smaller percentage under current law. If its Medicaid reimbursement were calculated in the same manner as states, the Island would receive an 83% reimbursement rate based on the Island's per capita income. Instead, Puerto Rico currently receives a set rate of 55%, meaning for every dollar the Island spends on Medicaid it receives only 55 cents in reimbursement.

Velázquez's bill provides Puerto Rico $15.1 billion in federal funding at an 83% FMAP for the Medicaid program for a five-year period starting in Fiscal Year 2020. Starting in 2024, the bill begins a 10-year transition period, after which Puerto Rico would receive the same financial treatment and FMAP as state Medicaid programs. During that period, it requires Puerto Rico to incrementally cover mandatory benefits under Medicaid that currently are not covered by the territory.

The legislation was cosponsored by Reps. Soto (D-FL), Serrano (D-NY), Grijalva (D-AZ), Espaillat (D-NY), Ocasio-Cortez (D-NY), and Garcia (D-IL) and Resident Commissioner Gonzalez-Colon (R-PR).

"Granting Puerto Rico equal access to federal Medicaid reimbursements as any other state is simply the right thing to do," stated Rep. Soto (D-FL). "The archaic Medicaid stipulations currently placed on Puerto Rico is causing dire health consequences to residents and massive debt on the island. Every American Citizen deserves equal access to Medicaid coverage."

"There is no reason today for the Medicaid reimbursement rate and federal funding share to be lower in Puerto Rico compared to the 50 states. This inequity has wreaked havoc on the island's health care system for decades. This bill will help ensure million of American citizens on the island have access to the same benefits and quality care as they would living in New York, Florida, or any other state. I thank my colleague Nydia Velazquez for leading this effort to fix an issue that should have been addressed a long time ago," said Congressman Serrano (D-NY).

"I'm excited about achieving full Medicaid funding for Puerto Rico. This effort has gone on for decades and should never have been opposed in the first place. The Obama administration and the PROMESA Task Force on Puerto Rico rightly considered it necessary for addressing Puerto Rico's long-term fiscal health, and it's time to get this done," said Rep. Raul Grijalva (D-AZ), the Chairman of the House Natural Resources Committee.

"The Medicaid program in Puerto Rico, as currently set by statute, is unsustainable and treats American in Puerto Rico like second-class citizens," said Rep. Jenniffer González Colón (R-PR). "It places financial pressures upon local resources to an extent not otherwise placed on any State. It creates a constant state of uncertainty for the local government, for the patients, and for healthcare providers with regards to the viability of the program, which Congress has had to constantly address to prevent a collapse of the Puerto Rico healthcare system due to lack of adequate funding."

"Since the start of my administration, we have been urging Congress to establish a permanent, long-term funding mechanism for Puerto Rico's Medicaid program," said Puerto Rico Governor Ricardo Rosselló. "The legislation presented today addresses our immediate need for stabilization,and provides a path to transition Puerto Rico's Medicaid program from the failed current block grant structure to a stable, state-like funding formula that advances Puerto Rico toward full equality in this critical federal healthcare program. We thank the Committee for incorporating our requests so that we can provide adequate assistance to our most vulnerable population. We thank Chairman Pallone, Resident Commissioner Jenniffer González Colón, Congressman Darren Soto, Congresswoman Nydia Velázquez and other sponsors for their support in introducing this critical piece of legislation."

The text of the bill is online here.

A summary is availablehere.

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