The clock is ticking for federal lawmakers to avoid what’s known as the “Medicaid cliff.”
Key funding for the Virgin Islands and Puerto Rico is set to expire at the end of September, and new legislation to prevent that cliff is expected to drop as soon as next week.
When it comes to Medicaid, territories are treated differently than the states, especially when it comes to funding. States receive upwards of 80 percent of their Medicaid funding from the federal government. But the dollars Puerto Rico, the Virgin Islands, and other territories receive is capped at 55 percent. That leaves the cash-strapped local governments footing the rest of the bill.
“That’s the reason a lot of the territories aren’t given all of the services of Medicaid because we don’t have the money to match the federal funds,” said Puerto Rico’s Resident Commissioner Jenniffer Gonzalez-Colon, the lone non-voting member representing the island’s 3.2 million residents in Congress.
Raising the cap is one of the solutions Congresswomen Gonzalez-Colon (R-PR) and Stacey Plaskett (D-VI) are pushing as the September deadline creeps closer. They first introduced that legislation in March. Without it, they fear many in the islands will lose their Medicaid coverage.
“In the case of the territories, the Constitution allows Congress to discriminate against the territories,” Gonzalez-Colon said.
“We see this as an opportunity for (Congress) to fix the inequities that have been done in Medicaid between all of the territories,” Plaskett said.
Some of that money has come under the Obama-era Affordable Care Act. But a Kaiser Family Foundation report released last week found that Puerto Rico could lose anywhere from 36-to-52 percent of its federal funding if the temporary funding isn’t renewed; the Virgin Islands could lose around 40 percent, according to KFF’s analysis.
Should Congress fail to act, the setback would be the latest facing the both of the island territories, where the medical infrastructure is still being rebuilt and replaced following Hurricanes Irma and Maria in 2017.
Both lawmakers are hoping for both equality and a permanent fix.
“That it’s not just a Band-Aid that’s going to take us into next year,” Plaskett said, “but that (lawmakers) really do some substantive, fundamental changes so that this is not an issue every year that we’re facing.”