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Watch U.S. House subcommittee hearing on Medicaid funding in territories

By on June 20, 2019

To address September funding cliff

SAN JUAN — The U.S. House Energy and Commerce’s Subcommittee on Health was holding a hearing Thursday, entitled “Strengthening Health Care in the U.S. Territories for Today and Into the Future.”

In her submitted testimony, the executive director of Puerto Rico’s Health Insurance Administration, Ángela Ávila, wrote that her department is looking forward “to working together to address the immediate issue of the impending Medicaid fiscal funding cliff and we look forward to finding a solution that can eliminate the unequal treatment for Puerto Rico, provide parity for Medicaid enrollees and the full benefits of the Federal Medicaid program for our citizens and our providers once and for all.”

During questioning, Ávila said Puerto Rico is losing 1.5 doctors a day to the states as a result of the lower reimbursement rates on the island.

“The large proportion of the population that receives healthcare benefits through Medicaid makes the Program a key pillar of Puerto Rico’s overall healthcare system,” Avila told the subcommittee. “As this Committee is well-aware, in just a few short months, in March of next year, the increased Medicaid funding Puerto Rico received in the aftermath of Hurricane Maria will expire.”

“Last month, Governor Ricardo Rosselló submitted Puerto Rico’s official Medicaid ask to Congress – $15.1 billion in funding at an 83% Federal Medical Assistance Percentage (FMAP) for five years in order to prevent the collapse of the healthcare system. The request would provide certainty in the short term while Congress works with the Government of Puerto Rico to determine a sustainable, long-term funding mechanism that eliminates the statutory inequity and allows us to meet the healthcare needs of our most vulnerable residents.

“This funding certainty and stability for Puerto Rico’s Medicaid program would also allow for responsible long-term budget planning and strategizing between the Government of Puerto Rico” and the congressionally established Financial Oversight and Management Board for the island.

Puerto Rico’s Health Insurance Administration, Ángela Ávila

Some 900,000 Puerto Rico residents could lose Medicaid coverage in September when hurricane relief aid expires, while Affordable Care Act funding is expected to run out in December.

“The territories are on the verge of a humanitarian and financial crisis if Congress doesn’t act swiftly to increase their Medicaid funding for next year and beyond,” House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-NJ) and Health Subcommittee Chairwoman Anna G. Eshoo (D-CA) said in the announcing release. “This hearing will be an opportunity to hear directly from representatives of the Medicaid programs in American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands about the challenges confronting their programs. Congress has a responsibility to ensure that Medicaid continues to provide for the health and well-being of the American citizens living in the territories with long-term certainty. To do that, we need to understand the unique funding difficulties and possible solutions for each of these programs.”

The following are the hearing’s witnesses and their written testimony:

Anne Schwartz, Ph.D.
Executive Director
Medicaid and CHIP Payment and Access Commission


Ángela Ávila
Executive Director, Administración de Seguros de Salud de Puerto Rico
Puerto Rico Health Insurance Administration


Sandra King Young
Medicaid Director
American Samoa State Agency


Maria Theresa Arcangel
Chief Administrator
Guam Division of Public Welfare


Michal Rhymer-Browne
Assistant Commissioner
Department of Human Services, U.S. Virgin Islands


Helen C. Sablan
Medicaid Director
Commonwealth of the Northern Mariana Islands State Medicaid Agency


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