Medicaid Challenges

Medicaid is a particularly important program in Puerto Rico because the population suffers from some of the highest rates of poverty and chronic disease, including diabetes and cardiovascular disease, in America. Despite their great need for Medicaid, the American citizens of Puerto Rico receive the lowest per-capita federal Medicaid funding in the nation. Medicaid is also funded differently in Puerto Rico than in the states, at the expense of the Americans on the island. In Puerto Rico, Congress funds Medicaid with capped, short-term funds—frequently jeopardizing the island's federal Medicaid funding.

MMAPA is calling on Congress to identify a long-term, permanent, bipartisan solution to address this impending Medicaid cliff. If the federal government continues to underfund Medicaid in Puerto Rico, the island will face an increasing risk of a humanitarian crisis.

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Medicaid and the Children's Health Insurance Program (CHIP) cover 1.52 million Americans in Puerto Rico—approximately 50% of the island's population. And yet, in FY2020, federal Medicaid per capita spending in Puerto Rico was just:

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• 64% of the lowest state

• 32% of the mainland average

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This lack of funding has strained an already broken system. As a result of this chronic underfunding, thousands of physicians have fled the island and essential investments in diagnostic and treatment equipment have had to be deferred.