Hearing Planned on Territories Medicaid Cliff

Rep. Gregorio Kilili Camacho Sablan of the Northern Mariana Islands, vice chair of the House Natural Resources Committee for Insular Affairs, has called a hearing on Thursday about the pending Medicaid funding shortage in the U.S. territories.

Esther L. Muna, Chief Executive Officer of the Northern Mariana Island Commonwealth Healthcare Corporation, and Medicaid directors from the Mariana Islands, American Samoa, Guam, Puerto Rico, and the U.S. Virgin Islands have been invited as witnesses.

The hearing is to be held at 10:03 a.m. on Thursday, May 23, at the Longworth Building. The title of the hearing is “The Insular Areas Medicaid Cliff.”

Angeles Avila will represent the government of Puerto Rico. According to El Nuevo Dia, Avila will testify that Puerto Rico could face a Medicaid cliff — the end of all available Medicaid funds — as early as April of 2020. 600,000 people could lose their health care access if this takes place.

“The Medicaid program can not take one more cut ,” Ávila told El Nuevo Dia in an interview.

Puerto Rico is in a different position from the States when it comes to Medicaid. States receive a proportion of their needed public health care funding from the federal government. If there is greater need, the funding increases.

Puerto Rico also receives a percentage of funding — but it is a smaller percentage. What’s more, there is a cap on the funding. If there are greater needs, the funding does not expand to meet those needs. As a result, Puerto Rico receives about $345 million each year for Medicaid and needs about $1,600 million.

One obvious consequence of this arrangement is that Puerto Rico can’t meet the medical needs of the people living on the Island. Another result is that, since Puerto Rico pays a disproportionate amount of the needed funding, medical costs cut into the already slender budget of the territory. Financial uncertainty in healthcare also contributes to the number of doctors leaving the Island, and to ongoing financial challenges for Puerto Rico’s hospitals.

Some lawmakers, including Stacey Plaskett (D-VI) and Darren Soto (D-FL), want to see an end to the Medicaid cap. While it is legal for Congress to treat territories differently from States, it is not required. Congress could change the system.

Others want supplemental funding to create a temporary solution. This has been the approach in the past — staving off the Medicaid cliff every few years.

Watch the livestream. 

The event takes place on Thursday, May 23, at 10:03 a.m. Eastern time.

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