Sending Office: Honorable Jenniffer Gonzalez-Colon
Please join me for a staff briefing on the state of health care in Puerto Rico. Experts will provide an overview of the Puerto Rico health care system and the unique challenges that the territory faces.
Like the other U.S. territories, Puerto Rico’s Medicaid funding is subjected to a statutory 55% Federal Medical Assistance Percentage (FMAP) rate, as well as an annual funding cap. Once the cap is reached, the island is required
to either fully cover the costs of Medicaid services, or suspend them until the following fiscal year.
Historically, Puerto Rico has relied on additional sources of funding, including disaster relief federal funds, to continue providing health care services under Medicaid. After Hurricane Maria, Puerto Rico was granted 100% FMAP
for 2 years, which is set to expire at the end of FY 2019. The island was also awarded close to $4 billion in Medicaid funding for two years, set to last through the end of FY 2019. Failure to act before September would revert PR to the pre-Obamacare scenario,
a 55-45 FMAP and $350M plus funding cap.
Additionally, Puerto Rico’s healthcare system is also highly reliant on Medicare Advantage, with roughly 75 percent of eligible Medicare beneficiaries enrolled in the program. Despite having higher enrollment rates and often higher
input costs, MA payment rates in Puerto Rico are currently 43 percent below the national average. This underfunding contributes to larger systemic problems, including lower provider reimbursement rates, provider shortages, and high-levels of migration off
The briefing will provide background and data on the importance of bringing equality under federal health care laws and addressing the ongoing health care crisis on the Island.
The Kaiser Family Foundation
The Moran Group
Former Gov. Luis Fortuño Burset
Angie Avila, Executive Director of the Health Insurance Administration (ASES) in Puerto Rico
Christian Sobrino, Governor’s Representative to the PROMESA Oversight Board
Date: Wednesday, May 22. 3:30 pm in room 2318, RHOB. For more information or to RSVP, please contact Natalia Gandia at 202-225-2615 or
Member of Congress
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