If Congress doesn’t act before October, the Puerto Rican health system will fall off a fiscal cliff, which will leave 600,000 Americans without healthcare.

Angela Avila, executive director of the Health Insurance Administration (ASES, Spanish acronym) cautioned that the U.S. territory’s Medicaid funding would run out by the end of 2019. The projected shortfall is $1.2 billion and will impact hundreds of thousands of Puerto Ricans.

Puerto Rico has a long history of economic woes, and the mainland has a long history of ignoring those woes. For instance, after Hurricane Maria, Puerto Rico was without power for almost a year. This was only partially due to the hurricane’s damage.

Decaying infrastructure in desperate need of repair was a major factor in the outage. The Puerto Rico Electric Power Authority (PREPA) had attempted to file for bankruptcy, as it could not afford the maintenance desperately needed, but its effort to do so was blocked by the U.S. Supreme Court.

Some people in the White House don’t even realize Puerto Ricans are Americans. 69 Republicans in the House of Representatives voted against Hurricane Maria disaster relief, and President Trump has been hostile toward the island. Some Puerto Ricans think the only way to attain basic respect and dignity as American citizens would be statehood.

Whether statehood would help the Medicaid crisis or not, some manner of long-term solution is desperately needed. While addressing the 2019 shortfall is important, that same level of funding won’t be enough in 2020.

Puerto Rico governor Rosselló Nevares (New Progressive Party) asked Congress to allocate $3 billion annually for the next five years and raise the federal responsibility for Medicaid funding to 83% in an effort to form a long-term solution to the commonwealth’s crisis.

Natalie Jaresko, executive director of Puerto Rico’s Financial Oversight and Management Board (tasked with overseeing the island’s bankruptcy), called on Congress to fund Medicaid at a level more closely tied to the needs of the island’s low-income community.

“The Commonwealth’s recovery and fulfillment of PROMESA’s (Puerto Rico Oversight, Management, and Economic Stability Act) objectives will be significantly aided by the Congress legislating a long-term Medicaid program solution to mitigate the drastic reduction in federal funding for healthcare in Puerto Rico that will happen later this year absent congressional action,” she said.

Congress has until the 2020 fiscal year begins in October to adequately fund Puerto Rico’s healthcare system.


Katelyn Kivel is a contributing editor and senior legal reporter for Grit Post in Kalamazoo, Michigan. Follow her on Twitter @KatelynKivel.


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