Puerto Rico Governor Ricardo Rosselló has sent letters to the governors of several states asking for their help in persuading their state delegations in Congress to help address the rapidly approaching drop in federal health care funding for Puerto Rico, known as the Medicaid Cliff.
The letter, as first reported by NBC news, was sent to the governors of Florida, Massachusetts, Connecticut, Ohio, New Jersey, Georgia, New York, Texas, Pennsylvania, California, Illinois, Virginia, and Wisconsin – states that have a large number of voting representatives in Congress. Puerto Rico has no voting representatives in Congress and has only one non-voting Resident Commissioner even though its residents are U.S. citizens because Puerto Rico is a U.S. territory.
Puerto Rico receives much less in Medicaid funding than states with comparable populations and poverty levels. The territory has a cap: a maximum level of funding provided by the federal government. When that money runs out, Puerto Rico receives no further funding for the year. Medicaid funding in states is not capped and is limited only by a formula. Puerto Rico received additional funding in the Affordable Care Act (ACA) – although states were eligible to receive more – but that funding is expected to run out, sending Puerto Rico off the metaphorical cliff before the end of 2017.
Gov. Rossello therefore wrote to governors with whom he had connected at the National Governors Association annual winter meeting to ask for support in getting the attention of the U.S. Congress before it’s too late.
“This could lead to a full-blown collapse of our healthcare system,” he wrote to Florida’s Governor Scott. “Moreover, if this issue is not addressed by Congress in the very near future the fallout will be felt not only in Puerto Rico but also in the states, because the already high rate of migration of the U.S. citizens moving from Puerto Rico to the states will likely increase significantly, affecting Florida in particular.”
Rossello pointed out that large numbers of people are leaving Puerto Rico for the States, and that this “devastating loss” is bad for Puerto Rico’s economy.
“We are willing to do our part to provide greater accountability, increased spending controls, and prosecute any fraud, waste and abuse tied to federal healthcare dollars,” he wrote. “However, Congress must find a way to include Medicaid funding for Puerto Rico at current levels until ACA replacement comes into effect and must also help Puerto Rico obtain more equitable and fiscally sustainable federal healthcare funding going forward.”
Rossello asked Scott to “activate” the Florida representatives to act as “a voice of reason” in the discussion on Puerto Rico in Congress. He also outlined the potential costs to Florida of seeing an increase in Puerto Ricans moving to Florida in search of adequate healthcare.