Center for American Progress

RELEASE: Congress Must Act To Prevent Severe Medicaid Funding Cuts for Puerto Rico

RELEASE: Congress Must Act To Prevent Severe Medicaid Funding Cuts for Puerto Rico

Washington, D.C. — Puerto Rico is set to lose critical Medicaid funding this December, with a 21 percentage-point cut to federal matching funds for the territory. This will have devastating consequences for its already fragile health care system and endanger access to care. 

A new analysis from the Center for American Progress makes clear that Medicaid has long been underfunded in Puerto Rico and calls on Congress to take action to ensure adequate funding. 

Nearly half of Puerto Rico’s residents received health coverage through Medicaid as of 2021. Despite the territory’s high poverty rate, which would qualify it for a higher federal Medicaid assistance percentage (FMAP) if it were a state, the FMAP for Puerto Rico—like all U.S. territories—is statutorily capped at 55 percent. If it were treated like a state, Puerto Rico would be receiving 83 percent. Through legislation associated with the COVID-19 pandemic, Congress temporarily raised Puerto Rico’s and other territories’ FMAP to 76 percent, but that is set to expire December 16. 

“A drop in funding would be devastating for Puerto Rican residents, given ongoing health needs, limited health system capacity, the high poverty rate, and the most recent natural disaster, Hurricane Fiona,” said Nicole Rapfogel, a research associate for the Health Policy team at CAP and author of the column. “Congress needs to ensure adequate Medicaid funding for the immediate future and apply the same FMAP formula used in states to Puerto Rico and other territories to provide equitable, predictable, and adequate funding.” 

Read the column: “Without Congressional Action, Puerto Rico Faces Severe Medicaid Funding Cuts” by Nicole Rapfogel 

For more information or to speak with an expert, please contact Julia Cusick at [email protected]. 

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