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What Will Happen to Veterans Hospitals under Free Association?

Puerto Rico is home to some 72,679 veterans, according to the U.S. Census Bureau. There are currently 10 Veterans Administration medical facilities on the Island.

The most recent figures from the Veterans Administration (VA) show that the VA hospital in San Juan received just 2 of 5 possible stars in their official review. There are also clinics or medical centers in Arecibo, Mayagüez, Guayama, Ponce, Utuado, Ceiba, Comerio, and Vieques.

Health care is provided for low-income vets at no cost.

How could a change in Puerto Rico’s political status affect VA health benefits?

Statehood would not have a negative effect on veterans’ benefits. The U.S. Constitution guarantees that new states enter the Union on “an equal footing” with existing states, so a new state of Puerto Rico would receive the same benefits as states do.

Independence, with or without a Free Association arrangement, would change that position. Federal law prohibits VA hospitals from operating in foreign countries, including the Freely Associated States (FAS) of Palau, the Marshall Islands, and the Federated States of Micronesia, where many bloody battles in WWII took place.

Under independence – with or without Free Association – the VA hospitals currently operating in Puerto Rico would likely close based on the precedent that exists today.

Even though they are not U.S. citizens, the citizens of the FAS nations can serve in the U.S. military, and they can receive VA health care services if they subsequently move to a state. However, there are no VA hospitals in their home countries.

If veterans from the Freely Associated States return home, they do not have access to veterans’ hospitals or related services and facilities.

In 2019, a bill was introduced in Congress to study the possibility of providing VA medical facilities for the COFA countries. However, this bill was not acted upon.

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