Earlier this week, health care reporter Marga Parés of El Nuevo Día published an article examining the impact of the recently passed federal spending package on Puerto Rico's Medicaid program. This spending bill, which was signed into law by President Biden on December 29, includes up to five years of Medicaid funding for Puerto Rico, providing stability for the island's health system, which, unlike the states, is funded with capped, short-term funds.

The article included commentary from senior leadership of the Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA), a non-profit composed of the leading Medicaid and Medicare Advantage organizations on the island. These MMAPA board members noted that while Puerto Rico will be receiving unprecedented Medicaid funding, it still falls short of an equitable comparison to other U.S. states and territories.

"We are taking a big step (with more funds allocated to the program), but there are still some big gaps," said Roberto Pando Cintrón, president of MMAPA.

"The local government, which manages Medicaid, says we have to cover some benefits, but the compensation is extremely low. That ́s when those gaps arise. To cover that (which is required), other areas are affected, such as payments to providers," said Orlando González Rivera, MMAPA board member and president of MMM Healthcare, LLC & MMM Multi-Health in Puerto Rico.

Americans in Puerto Rico face some of the highest rates of poverty and chronic health issues in the country, but inequitable federal Medicaid funding has made it difficult for them to get the care they need. This funding package marks a milestone toward creating stability for the system and delivering better outcomes for patients on the island.

"[The new funding level] gives the program stability like never before. But Puerto Ricans deserve the same quality (in Medicare and Medicaid) as (the rest of) the United States," said Roberto García Rodríguez, MMAPA board member and president and CEO of Triple-S Management Corporation.

MMAPA leaders also stated that this progress doesn't solve all of the problems facing the island's health care system, including inequitable funding rates for Medicare Advantage and gaps in essential benefits.

"We are still below 41 percent of the Medicare Advantage payment, but we have managed and done much more with less. That highlights our ability to work effectively," said Pando Cintrón.

“(Medicare) Advantage participants have broader coverage. They are people with the same (health) conditions, but we pay with the same (allocated) money,” said Juan Domínguez, MMAPA board member and vice president of First Medical corporate development.

The full article can be found here.
Categories: ICYMI