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Report: Mass Puerto Rican outmigration raising US healthcare costs

By on January 16, 2018

SAN JUAN – In addition to having to rebuild Puerto Rico’s electrical grid, other major events in the aftermath of the 2017 hurricane season include a massive outmigration of residents to the U.S. mainland. The storms’ repercussions in healthcare are affecting the system and “alerting [to] the need for funding revision,” reveals the Impactivo Consulting report, “Weighing the Effects of Puerto Ricans to the U.S. on Health System Funding,” reveals.

The outmigration of Puerto Ricans settling stateside, an issue that Congress is currently discussing, is changing the “face, cost and structure” of healthcare needs, as well as the “economic and political repercussions resulting from this unforeseen migratory pattern,” a press release issued by the consulting firm says.

An example of the precariousness of the situation arose Tuesday, when Rep. Darren Soto became the subject of an ethics complaint when video of him surfaced telling Puerto Rican evacuees they should say in federal medical benefit forms that they are staying in Florida to qualify for said benefits.

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According to the report, Puerto Ricans are migrating stateside at a pace not seen since the island’s residents became U.S. citizens in 1918. “The calamities of hurricanes Irma and María have been a decisive blow for residents already facing a decade long recession, a bankrupt local government and a federal funding crisis that has been cutting bare health care programs,” the San Juan-based consultancy says.

Impactivo, a B Corporation-certified firm specializing in healthcare, has previously published several reports on how federal Medicaid funding caps, the reduced Federal Medicaid Assistance Percentage (FMAP) and “unequal treatment in Medicare Advantage for Puerto Rico, potentially implemented by Congress as cost containment measures, have cost Federal and State governments more to cover those who have left the island than it would have cost them to provide for Puerto Rico the same level of funding provided to States due to the externalities produced by migration.”

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The firm’s January Issue Brief delves into why providing the island with equal treatment to the States with federal healthcare and human services programs “would prove to be the right thing to do, as well as the most fiscally responsible solution for the government, both federal and state,” the firm explains.

“Our research shows that two-thirds of people living in Puerto Rico have recently considered moving to the United States to receive better health systems, making this issue top of mind when people decide to migrate,” said María Levis, CEO of Impactivo. “Many Puerto Ricans who moved to the states after Hurricane Maria are still interested in returning home and increased federal investments in health care would create an environment of confidence which would facilitate their return,” she added.

“Major political shifts,” the report notes, “could also result from this migratory wave in upcoming electoral cycles, as Puerto Ricans have a high voting-participation tradition, and potentially impact the political structure in the states where they have settled…. The 2018 midterm elections will put all 435 seats in the House of Representatives on the line, as well as 33 Senate seats and almost 40 governor posts, at a time when more Puerto Ricans are likely to express their political voice,” the release reads.

Among potential solutions presented to “alleviate the impending situation include funding to strengthen the Puerto Rico health system through a Disaster Relief Package, a permanent solution for Medicaid inequities through the Children’s Health Insurance Program (CHIP) Reauthorization Act, [which is] still pending legislation, and returning Medicare Advantage formulas to pre-Affordable Care Act levels. These measures could help alleviate the island’s funding crisis, and facilitate the process for Puerto Ricans to return home. With an improved healthcare service scenario, many families are likely to return which would help the island revitalize.”

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Moreover, the firm finds, statistical data indicate that more than 300,000 people have left the island since September. “Projecting those numbers into the next few years could mean an exodus of more than 470,00 Puerto Ricans by 2020. That would account for 14% of the island’s population. In the majority of cases, those leaving are settling in the continental U.S. Some 212,000 Puerto Ricans may migrate to one of the 50 states in the next year alone, with Florida expected to welcome the largest influx – of perhaps 82,000 native islanders,” experts cited in the report said.

The issue brief may be accessed here.

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