At a hearing, the Senator said the administration’s proposed changes to the MA risk model “could impose the largest year-to-year reduction in federal health funding to Puerto Rico, a change that is harmful not only to the most vulnerable beneficiaries but to the island’s health care system and economy.”
At a Senate hearing this week, Sen. Bob Menendez (D-NJ) expressed serious concerns that the Biden administration’s proposed changes to the current MA risk model would threaten the wellbeing of Puerto Rico’s most vulnerable populations.
“I’m concerned that the proposed advanced notice Medicare Advantage rate announcement will create further health disparities for the 640,000 Medicare Advantage beneficiaries in Puerto Rico,” said Sen. Menendez during a Senate Finance Committee hearing on Wednesday that featured Health and Human Services Secretary Xavier Becerra as a witness.
Sen. Menendez expresses concerns about the impact of Medicare changes for Americans in Puerto Rico during a Senate hearing this week.
“As you know, Puerto Rico seniors overwhelmingly depend on the MA program with an MA penetration rate of 94 percent among beneficiaries eligible for Medicare Parts A and B. The proposed changes could impose the largest year-to-year reduction in federal health funding to Puerto Rico, a change that is harmful not only to the most vulnerable beneficiaries but to the island’s health care system and economy, one that we have been working towards improving.”
“Further, the MA program in Puerto Rico supports health access and equity by filling gaps in care resulting from the island’s exclusion from many other federal health benefits. I’m concerned these changes could undermine progress we’ve made to date to address disparities on the island, including recent funding gains achieved for the Medicaid program, which I fought for,” he said.
According to a recent report, the proposed changes to the current MA risk score model could lead to a 9.1% reduction in MA payments in Puerto Rico, marking a disproportionate decrease in funding compared to the national average reduction of 3.4%. MMAPA believes this reduction will hurt the most vulnerable and marginalized Americans on the island.
Today, 1 in 5 people in Puerto Rico are MA beneficiaries, making the island home to the largest share of MA beneficiaries across the states. These Americans often face social determinants of health that negatively impact their wellbeing, such as food insecurity, lack of transportation, and poor housing. If the proposed changes to the risk model are implemented, many providers and MA organizations expect to lose the funds necessary to provide essential health care benefits and services to low-income and chronically ill Americans on the island, particularly those with diagnoses for diabetes and congestive heart failure.
Puerto Rico’s exclusion from equitable funding and distinct statutory treatment has been a perennial issue, and the island continues to be omitted from important policy discussions despite promises from multiple successful presidential campaigns to make the issue a priority. Today, MA rates on the island are 41% below the national average and 23% below the neighboring Virgin Islands. MMAPA has previously called on the Administration to set fair rates for MA in Puerto Rico and end decades of inequity on the island, but the proposed changes to the Advance Notice signal more challenges to come as providers in Puerto Rico fight to secure equitable health care for patients across the island.
The full video of Sen. Menendez’s comments about Puerto Rico can be found here.
The Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA) is a non-profit organization comprised of the leading Medicaid and Medicare Advantage organizations in Puerto Rico. Founded in 2009, MMAPA is dedicated to promoting policy solutions to solve Puerto Rico’s healthcare challenges.
Follow MMAPA on Twitter at @mmapapr or visit our website, mmapapr.org.