Recognizing that healthcare funding for Puerto Rico was not included in federal legislation introduced last week to repeal the Affordable Care Act (Obamacare), Gov. Ricardo Rosselló’s top aide in Washington, D.C. has vowed to continue to fight for critical resources.
“It is what it is. We are a territory. These types of bills never include Puerto Rico or the territories. Now the door opens for us to keep working on them to include Puerto Rico,” said Rosselló’s D.C. office executive director Carlos Mercader, as first reported in Reorg research.
As previously reported, Puerto Rico’s share of federal Medicaid funding is capped, but the fifty states can receive unlimited funds consistent with a formula as long as they share the cost. Puerto Rico and the other territories received increased funding under the Affordable Care Act, but this supplemental healthcare funding will run out in 2017, resulting in a healthcare funding gap of roughly $2 billion or more during 2018 and 2019. Problems are expected to become acute in the spring of 2017 when annual contracts with insurers and healthcare provides must be renewed – a situation being referred to as the “Medicaid cliff.”
“[T]he future financing of the Medicaid program in Puerto Rico is a serious and urgent issue,” wrote the Congressional Task Force on Economic Growth in Puerto Rico (Task Force) in its December 2017 final report. “[A]n equitable and sustainable legislative solution to the financing of Puerto Rico’s Medicaid program should be enacted early in 2017,” the Task Force concluded.
The Task Force recommended that “Congress begin to address the [Medicaid cliff] funding issue early in calendar year 2017 to enable the Puerto Rico Medicaid agency to engage with more certainty when formulating capitation payment contracts with its managed care organizations for Puerto Rico Fiscal Year 2017-2018, which begins on July 1, 2017.”
Puerto Rico’s Medicaid program is run less expensively than Medicaid programs in the states, and the Task Force noted in its final report that supporting Puerto Rico’s Medicaid program makes long term financial sense: “Inadequate federal financing for Puerto Rico’s Medicaid program may “save” federal taxpayer dollars in the short term. However, over time, these savings are likely to be at least partially offset by the additional costs borne by the federal government and state governments as a result of conditions-based migration from Puerto Rico to the U.S. mainland.”
Resident Commissioner Jenniffer González-Colon has also filed legislation to address the Medicaid cliff .