Resident Commissioner presents findings of federal report on the condition of the health care system in Puerto Rico
San Juan, Puerto Rico – Resident Commissioner Jenniffer González-Colón, together with Puerto Rico Health Secretary Rafael Rodríguez-Mercado, presented reports prepared by the US Department of Health and Human Services (HHS) that detail the discriminatory treatment in federal programs due to the territorial status and the loss of health care funding facing Puerto Rico.
The reports paint a picture of unequal treatment for Puerto Rico under the Affordable Care Act (ACA) and directly state the hard reality of the health care situation in the territory: "3.5 million Americans living in the Commonwealth of Puerto Rico do not have Access to a health care system considered standard in the rest of the nation." It also portrays how fiscal deficiencies under the e García Padilla administration compromised the local health care system.
"I am going to fight this battle together with the Health Secretary, to work at correcting the deficiencies identified by HHS in the past administration's handling of the issue. Ours is a different team, one that will be dilligent in our duties and go even further, to maximize our Access and utilization of federal funds," González-Colón stated.
"In the face of the situation of the Obamacare [funding exhaustion], the people of Puerto Rico can be assured that I will not just stand with my arms crossed but we will all fight together to bring health care excellence to Puerto Rico", added Health Secretary Rodríguez-Mercado.
Among the conclusions in the reports are that the Puerto Rico health care system was already facing difficulties before having to face new burdens such as the zika outbreak.
Among the other findings of the reports are acknowledging the problem of a flight of professionals and a clear evidence of a shortfall in specialists; poor performance in preventive areas such as immunizations and cancer screenings; a proportion of people self-reporting as in "fair to poor" health that is twice the national rate, and that it is difficult to obtain updated statistics and more studies are needed.
The report underlines how the colonial condition is one obstacle to progress in the health care system: "From an enduring economic crisis to underlying statutory disparities, Puerto Rico faces a combination of unique circumstances that not only hinder improvement but risk further deterioration".
Reports support legislation presented by González-Colón
These reports validate the thinking behind the Resident Commissioner's legislative initiatives. As promised in her campaign, on the day following her inauguration she filed two bills, one to protect Medicaid funding for the nation's territories and another to make Medicare Part B enrollment in Puerto Rico on the same basis as in the rest of the states, acting so to in anticipation to a loss of funding and correcting the discriminatory treatment endured by Puerto Rico in health care.
Even before her swearing in, González-Colón had already met with the nominee for HHS Secretary, Tom Price, and other congressional leaders about these issues.
The first of her two bills, H.R. 259, would ensure the appropriation for Puerto Rico for Medicsid would remain at its current funding level of $1.68 billion, rather than cease in FY2019 as it would under a sunset provision in ACA. Meanwhile H.R. 261 seeks equal treatment for the US citizens in Puerto Rico who qualify for Medicare Part B. Both were steps supported by the bipartisan Congressional Task Force on Puerto Rico in the last Congress.
While announcing that she would file more legislation to end the discrimination against the American citizens in Puerto Rico in health care services, she reminded that the full and unconditional equality that Puerto Rico wants and need in those matters can only be achieved through statehood.
Affordable Care Act discriminatory
The Resident Commissioner stated: "ACA was discriminatory in its design, providing for a finite sunset in funding for the territories while for the states it had recurring funds. Because of this unequal treatment it is necessary to change that model. ACA allows legally to have American citizens treated in a discriminatory way in Puerto Rico and the other territories, worsening what is already a second-class citizen treatment. This is why with my Republican colleagues in the new Congress, as Part of the republican Conference in the House in DC, and together with the President Elect, we will be working to replace it with a system focused on the needs of the patients".
The Congresswoman explained that ACA expands the number of Medicaid eligible people in both states and territories, but sets much tighter limits on funding for the territories.
This inequality is seen in at least three major aspects: Puerto Rico was appropriated a fixed total of $5.487 billion in Medicaid funds, set to end on September 30 2019, and no such limits for the states; it required Puerto Rico's match for funding to be on a 45/55 basis for all funds while there are items for which states were 90 to 100% federally covered; the middle income subsidy in the states were not capped but for Puerto Rico again there was a fixed amount and date of $925 million until 31 December 2019, which was inadequate to start with as the Government Accountability Office had estimated a $1.5 billion need.
Even though the funding was supposed to last until 2019, the García Padilla administration's fiscal management deficiencies sped up the exhaustion of these funds, creating a potential situation of 470,000 residents losing health insurance.