The Obama administration is clamoring for Congress to provide Puerto Rico with more money to strengthen the debt-riddled territory’s Medicaid program, but Republicans say Obamacare shares some of the blame.
Puerto Rico’s government ran out of cash to fund normal operations earlier this year, and the White House has asked Congress to boost funding for Puerto Rico’s Medicaid program by $30 billion. Puerto Rico has debts and unfunded pension liabilities of at least $117 billion, according to the Senate Finance Committee.
“A true solution for the 3.5 million Americans living in Puerto Rico, including reforms to strengthen Puerto Rico’s Medicaid program, such as raising the federal share of Medicaid funding, requires Congress to act,” said Department of Health and Human Services Secretary Sylvia Mathews Burwell Thursday.
HHS outlined other actions it wants to use to address the issue.
This year, the agency gave Puerto Rico access to the Medicaid Drug Rebate program that gives access to rebates to lower drug costs.
But the department is pressing for more, asking for Congress to raise the federal matching rate for Medicaid for territories such as Puerto Rico.
Currently the matching rate is set at 55 percent, and HHS wants it to be raised to 83 percent. This is the same share that is employed in the U.S.
HHS also wants to expand Medicaid to 100 percent of the federal poverty level, as currently the program is set at 50 percent.
Congress has been cold to President Obama’s budget since it was released last week. Lawmakers also did not include any funding for Puerto Rico in the spending bill passed in December.
Congressional Republicans blamed the Affordable Care Act for part of the problem with Medicaid funding. The law gave Puerto Rico’s Medicaid program an additional $5.4 billion in funding from 2011 through 2019.
“Apparently, the authors of the [Affordable Care Act] wrote a Medicaid funding cliff for Puerto Rico into the law,” according to a statement from Sen. Orrin Hatch, R-Utah, chairman of the Senate Finance Committee for a recent hearing. “Now we are being told — by some of those same authors, no less — that this funding cliff is unfair and must be undone.”
Puerto Rico is exempt from the law’s individual mandate for getting health insurance.
Administration officials have met with lawmakers on the issue.
“We have been very clear in public and in meetings that we don’t believe that congressional inaction is an option,” an HHS official said.
Meanwhile, Puerto Rico is one of the areas hit hard by the Zika virus spreading through the Americas.
The Centers for Disease Control and Prevention Director said the island could be hit with tens of thousands of Zika cases.
A portion of the administration’s request for $1.8 billion in emergency funds would go to Puerto Rico to help address the outbreak.
