Tuesday, January 31, 2023

Resident Commissioner and Health Secretary Discuss Medicaid Negotiations

By on July 23, 2021

Resident Commissioner Jenniffer González and Health Secretary Carlos Mellado participated Friday at the Health Services Administrators College (CASS by its Spanish acronym) annual convention to speak about the most recent developments in U.S. Congress concerning the island’s Medicaid Program.

The conference was dubbed “Government/Congress Update Healthcare Projects.”

Mellado said that he spoke with Congressmen about the island’s current healthcare situation and what the local government believes could be important in the Medicaid Programs for the population.

“And based on what the resident commissioner has achieved, which I believe is the first time we have five years of a recurrent budget,” Mellado said while noting that changes to improve the program could be achieved.

“But parting from having a fiscal cliff that would have achieved nothing compared with what we have now,” Mellado added.

Mellado highlighted that a permanent solution is to continue a path to receive state-like treatment, in which policy changes would need to be implemented, such as an increase in the federal allotment and applying a state Federal Medical Assistance Percentage (FMAP).

The resulting improvements would include raising eligibility levels above 85 percent of the federal poverty levels and providing missing mandatory benefits.

Meanwhile, González said that currently, “we are in negotiations with Congress.”

She said that although the U.S. House Energy and Commerce Committee voted to advance 16 health bills to the full House of Representatives, including House Resolution 4406, the “Supporting Medicaid in the U.S. Territories Act” that includes five years of Medicaid funding for Puerto Rico, an allocation of some $3 billion and a Federal Medical Assistance Percentage (FMAP) FMAP of 76 percent, she is still lobbying to achieve higher funding before the bill goes down to a vote at the full House of Representatives and later at the U.S. Senate.

“We have suggested to include funding for additional benefits (adult vaccinations, diabetes supplies, non-emergency transportation, and Part B premium for duals),” González said. “We have also suggested shortening the funding extension to four years instead of five years with the same amount of funding, making the new proposal budget-neutral.”

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