Medicaid is a particularly important program in Puerto Rico, where the population suffers from the highest rates of 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 country. What's more, the Medicaid is funded differently in Puerto Rico than in states. In Puerto Rico, Congress funds Medicaid with capped, short-term funds—frequently jeopardizing the island's federal Medicaid funding.
The Medicaid funding and federal matching rate established by Congress in 2018 is set to expire in fall 2019. MMAPA calls on Congress to identify a long-term, 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.
Medicaid and the Children's Health Insurance Program (CHIP) cover 1.67 million Americans in Puerto Rico—approximately 50 percent of the island's population. And yet, in 2016, federal Medicaid per capita spending in Puerto Rico was just:
- 37 percent of the lowest state
- 26 percent of the mainland average
Hurricanes Irma and Maria further strained the health care situation in Puerto Rico with the devastation they left behind. With nearly all medical facilities suffering damage or being destroyed, quality care became even more scarce. As a result, thousands of physicians have fled the Island, creating a crisis of access.