Medicare has long been underfunded in Puerto Rico. Americans on the Island pay the same Medicare payroll tax as mainland citizens but receive the lowest level of federal Medicare spending in the country. Federal underfunding of Medicare Advantage (MA) in Puerto Rico has contributed to a health care crisis in the wake of the COVID-19 pandemic.
While more than 80% of Puerto Rico's Medicare enrollees elect benefits through MA plans, only 30% of mainland enrollees do. And yet, MA in Puerto Rico is:
- 41% below the U.S. average in federal benchmark funding
- 37% below the lowest state's federal benchmark funding
- 23% below the U.S. Virgin Islands' federal benchmark funding
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.