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The Dorado Medical Center, in Dorado, Puerto Rico, on September 30, 2017. Photo: Hector Retamal/AFP via Getty Images
The Dorado Medical Center, in Dorado, Puerto Rico, on September 30, 2017. Photo: Hector Retamal/AFP via Getty Images

Puerto Rico is at risk of losing Medicaid funding

How Puerto Rico is fighting for funding to keep thousands from losing healthcare.

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As Puerto Rico continues to recover from the COVID-19 pandemic, thousands could start losing healthcare access in a matter of months. 

Puerto Rican Health Secretary Carlos Mellado traveled to Washington on June 29, to meet with federal health officials to advocate for the need for more Medicaid funding. Although Puerto Rico is a U.S territory, it has a limited spending cap of Medicaid compared to the rest of the U.S., where Medicaid funding is not limited. 

This leaves the island to pick up the expenses that are left, as disparity in funding brings greater uncertainty to the Puerto Rican communities trying to access healthcare. 

According to the Center on Budget and Policy Priorities, in 2020, the island's Medicaid funding was capped at $375 million, although the projected expenses were suspected to reach $2.8 billion.

The long-standing issue of disparity in funding has caused a decline in the island’s healthcare system. Mellado met with lawmakers to not only continue the conversation, but also advocate for change in guaranteeing care for the elderly.  

As NBC News reported, Mellado said the disparity in funding has become difficult for Puerto Ricans to obtain medical services and treatments needed.

"We have a lot of disparity in services, and it's difficult because in Puerto Rico, there are problems obtaining durable medical equipment and long-term care treatment for patients," Mellado told NBC News. "They don't have access to that under the existing Medicaid coverage."

Although federal funding has increased in the past, it has been temporary and not allowed Puerto Rico to make necessary Medicaid improvements. 

"If they do not approve the budget, we fall into the cap, and that means that we are going to have just $300 million to fund our Medicaid expenses,” Mellado said in an interview with NBC News. “That's impossible to do with that amount." 

The Center on Budget and Policy Priorities said President Joe Biden’s impending economic recovery plan will give policymakers an opportunity to implement a more permanent fix to the financial disparities. 

“It would give the territories stable, adequate funding and put them on a path to align their Medicaid programs with state programs as quickly and completely as possible. Bills like this year’s H.R. 1722, which was first introduced as H.R. 3371, in the last Congress, provide one approach to giving Puerto Rico a pathway to funding parity and alignment over 10 years,” Center on Budget and Policy Priorities said. 

Biden’s recovery plan may help, but Mellado currently has to cut services and programs every two years depending on the funding Congress allocates to Puerto Rico’s Medicaid system.

However, he is still pushing for Puerto Rico to have equal access to Medicaid funding and hopes to find a more permanent solution that allows for more access to medical care. 

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