WASHINGTON – Puerto Rico health care providers, payers and stakeholders are pressing U.S. lawmakers and President Obama to increase funding for the territory's Medicaid and Medicare programs in pending legislation.
"We are extremely disappointed that the initial House discussion draft has not included any health care related provision," said officials from 10 groups, including the PR Hospital Association and the Puerto Rico Chamber of Commerce. "It is necessary for Congress to recognize the degree to which the Puerto Rico health crisis is intertwined with the economic crisis."
Puerto Rico's fiscal and debt crisis is driving its residents, particularly health care providers, to move to the U.S. for better opportunities, the groups said.
As a result, the territory's population is older and poorer, putting a strain on Medicare and Medicare programs, which already have "structural deficiencies" compared to those in the 50 states and District of Columbia, they said.
Puerto Rico's population declined more than 7% between 2004 and 2014, leaving older and poorer residents behind. In 2012, for the first time, the median age of the territory's population exceeded that of the U.S. mainland, according to the letter.
"Puerto Rico has far and away the highest Medicare Advantage (MA) penetration in the country to the point where that program accounts for approximately 50% of all health care dollars in the Commonwealth," the groups said. "Yet, due to prior disparate treatment and cuts included in the Affordable Care Act (ACA), reimbursements to MA plans in Puerto Rico have been reduced by 11% and are nearly 40% less than the national average."
"Additionally, while the coverage and subsidies provisions of the ACA may not apply to Puerto Rico, the revenue raising provisions unfairly still do, leaving our health care plans, the government of Puerto Rico and consumers to pay approximately $200 million under the ACA's health insurance provider tax in 2016," they said.
Medicaid is approaching a "cliff" where federal support to Puerto Rico for the program will fall nearly 75%, the groups said.
The letter, sent to House and Senate majority and minority leaders as well as the leaders of committees with jurisdiction over Puerto Rico, also was signed by officials from the Medicaid and Medicare Advantage Association of Puerto Rico, Puerto Rico Healthcare Crisis Coalition, PR IPA Association, Puerto Rico Medical Association, Puerto Rico Community Pharmacies Association, Primary Health Association of Puerto Rico, and Entrepreneurs for Puerto Rico. Rolance Chavier, Puerto Rico Delegate to the American Medical Association, signed it as well.
