The White House, Congress must move on parity in Medicaid funds for Puerto Rico

The United States Territory of Puerto Rico is facing a pending health crisis which could leave more than 500,000 U.S. citizens without health insurance coverage within a year. That’s a reality the Trump White House and the Congress cannot afford to ignore anymore.

Currently Puerto Rico receives around $1,300 million annually to fund its public health system. These allocations are used to provide healthcare services, including hospital and drug coverage, to almost 1.6 million citizens living below the poverty line. The elimination of those funds, as its stands right now, will have a crushing effect, clearing a path to make the Island the first U.S. jurisdiction to be submerged in a real health crisis.


President Trump and the Congress must act now, providing leadership to push forward an agenda that includes complete parity for the Island in the disbursement of Medicaid funds for the next federal fiscal year (FY), which starts on Oct. 1.

Because of our condition as the world’s oldest colony, Puerto Rico currently receives a 55 percent reimbursement of all Medicaid-related programs, including health care coverage for the poor. And only this because in 2011 Congress approved the Affordable Health Care Patient for America Act, commonly referred to as ‘ObamaCare’, which raised the level of funding from a pedestrian 25 percent to 55 percent. The cost of providing health coverage to the neediest on the Island surpasses the $2,400 million threshold.

With the expiration of ObamaCare and without any other comprehensive health care program on the horizon, its most likely that by FY 2019 we will be back on the 25 percent benchmark. In real money, that comes around $350 million and with our economy in a 12-year recession, mainly due to the colonial status, we simply do not have the resources to fund the programs. In contrast, all 50 states of the Union are allocated a minimum of 83 percent of Medicaid expenses.

There’s another issue closely related. If we go back to the 25 percent platform, our economy will receive a devastating blow, sure to plunge it into an historic collapse never seen in any U.S. jurisdiction. That’s because the health services industry in Puerto Rico employs an estimated 100,000 people directly and accounts for roughly 20 percent of our overall economic output.

Therefore, we need parity in funding. The White House and Congress should promote a bill that will allow us to reach the 83 percent level during the next four years, which will be enough for Congress to act on the admission request of Puerto Rico.

Puerto Rico does not want to be in this position, but decades of inaction by Congress and the Oval Office have left us without any other option. We need parity now. That’s why President Trump needs to take this issue into consideration and fast.

Jose Aponte-Hernandez is a state representative in Puerto Rico and is the former Speaker of the House for the territory.

The views expressed by this author are their own and are not the views of The Hill.

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