After an important step by Congress that provides more stability in Medicaid funding, MMAPA will continue to push for more equitable healthcare treatment for Americans in Puerto Rico, particularly the most vulnerable Medicare Advantage and dual eligible beneficiaries
February 27, 2023
After achieving important progress for funding stability for Medicaid in Puerto Rico in 2022, the Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA) is prioritizing critical and long overdue changes to other federal healthcare policies in 2023, specifically regarding inequities faced by Medicare Advantage (MA) beneficiaries and the dual eligible population. Roberto Pando Cintrón, President of MMAPA, released the following statement discussing how MMAPA will continue to push for better and more equitable healthcare treatment for Puerto Ricans, who are American citizens:
"We are appreciative and thankful for all the efforts that led to the approval of new Medicaid funding that provides basic stability for the program in Puerto Rico. Building on this momentum, MMAPA will continue leading efforts to advocate for equitable treatment of Puerto Rico's federal health programs, primarily for beneficiaries in Medicare Advantage, including those who are dual eligible for both Medicaid and Medicare," said Pando Cintrón.
"Federal Medicare Advantage rates for Puerto Rico continue to fall further behind the nation every year and are now 41% below the national average and 37% below the state with the lowest base rates. This inequity is combined with key exclusions of federal benefits that impact over 300,000 dual eligible beneficiaries. Our low-income seniors are excluded from core benefits to help pay for pharmacy coverage (like the Part D Low Income Subsidy), Medicaid support for Medicare premiums, and long-term care benefits. These inequities would be potentially exacerbated by CMS's proposed changes in the Medicare Advantage Advance Notice for 2024."
"In 2023, there is no shortage of work that must be done in the fight for better healthcare for Americans in Puerto Rico. The recently proposed changes in the Advance Notice will further reduce funding to the poorest areas across the nation, and Puerto Rico is already a national outlier for its low Medicare Advantage funding. We continue to analyze the impacts of the Advance Notice but we are extremely concerned that Medicare Advantage benchmarks for Puerto Rico will fall even further behind the national average in 2024, while plans deal with additional reductions due to unexpected risk score model changes. On top of that, the Part D benefit redesign the Inflation Reduction Act (IRA) left Medicare beneficiaries in Puerto Rico without the Part D Low Income Subsidy, which will also increase costs for plans in Puerto Rico serving dual eligible beneficiaries."
"We cannot forget that, even with the recent Medicaid funding stability, total healthcare funding in Puerto Rico averages approximately $5,200 per capita per year, compared with $14,170 per capita at the national level. The Medicare Advantage program serves 640,000 beneficiaries in Puerto Rico, and over 290,000 are dual eligible. Medicare Advantage beneficiaries in Puerto Rico need new administrative action by HHS and CMS to continue the momentum of closing disparities in the treatment of Puerto Rico by federal health programs."
"The Puerto Rico Medicare Advantage funding disparity perpetuates an imbalance in professional compensation and healthcare infrastructure that deteriorates every year. We remain hopeful that the HHS Health Equity Action Plan will result in meaningful progress with the release of the final Medicare Advantage 2024 Rate Announcement. MMAPA will present technical comments and will work with major stakeholders to request positive action for the most vulnerable beneficiaries in Puerto Rico."