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When Puerto Ricans are Outsiders

Roberto Cox Alomar, PDP candidate for resident commissioner of Puerto Rico, has criticized Social Security as a “program from the outside” that the territory can do without.

Labeling Social Security as a “program from the outside” is curious.  Social Security is one of the most fully integrated U.S. federal programs within Puerto Rico.  Puerto Ricans pay into the Social Security system through federal payroll taxes and receive the same standard benefits as other U.S. citizens when they hit eligibility age.  They are treated equally, not as “outsiders” subject to limitations.

This is not the case under virtually any other federal program.  Let’s start with Medicare.  Puerto Ricans pay into the Medicare system through their payroll taxes, but they are left out of some of the program’s basic components.  Puerto Rico is the only place in the U.S. in which individuals must proactively opt into Medicare Part B, which covers doctor services.  Those who can’t make it to the Social Security office to sign up – or simply forget or don’t know to go – pay a steep penalty.

There is a whole list of Puerto Rican inequities under Medicare.  If Puerto Rico were a state, doctors and hospitals would qualify for bonus payments for using electronic records, hospitals would receive higher reimbursement rates, doctors would be paid more, and seniors would receive subsidies to help them afford prescription drugs.

The inequity is even worse under Medicaid, which caps Puerto Rico’s benefits while states receive matching dollars virtually without limit.  In 2009, for example, Puerto Rico’s cap was $272.4 million; Oklahoma, which has roughly the same population at Puerto Rico, received close to $3.5 billion.  If Puerto Rico were a state, it would receive billions of additional Medicaid dollars, translating into improved health care services – and more of them.

Puerto Ricans fare no better under nutrition assistance.  While the rest of the country receives benefits based on need, Puerto Ricans again face a strict funding cap.  As we previously reported,  if Puerto Rico were a state, 220,000 additional individuals would have been eligible for nutrition benefits in 2010 and the average benefit would have been $23/month more.

Turning to the Temporary Assistance for Needy Families (TANF) program, we find yet another capped block grant for Puerto Rico that would be much more generous if Puerto Rico were a state.  Related funding streams – such as contingency funds and mandatory funds for child care – are completely off limits to Puerto Rico and eligible only to states.

Puerto Rico’s outsider status is perhaps most pronounced under the Social Security Income (SSI) program, which helps some of the poorest and most disadvantaged people in the nation – the blind, disabled and elderly.   Puerto Rico is excluded from the federal SSI program.  Instead, the Puerto Rican government receives an annual block grant valued at about $35 million.

If Puerto Rico were a state, the federal government would send SSI payments directly to recipients.  Their checks would be larger than under the current system, and more people would get them.  In 2010, Mississippi, the poorest state in the nation, received $742 million in SSI funding – more than twenty times the amount provided to Puerto Rico.  Roughly 125,000 people in Mississippi receive SSI benefits every month, in amounts ranging from $400 to $600.  In Puerto Rico, which has a much smaller population, only about 40,000 individuals receive the comparable benefit, and those who do get only $70 per month.

In the words of current resident commissioner Pedro Pierluisi:  “Of all the disparities that Puerto Rico faces because it is a territory, perhaps none is more damaging or unprincipled than its exclusion from the SSI program, which helps people who cannot help themselves – or who can only do so with great difficulty.”

Under Social Security, there is an exact match of equal rights and equal responsibilities between Puerto Ricans and other U.S. citizens.  Under other programs, Puerto Ricans are disadvantaged because they are not a state, which makes them “outsiders” in the system that governs them.


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