A recent poll of voters in Puerto Rico indicated that merely 32% believed that statehood would deliver greater benefits and increased funding for healthcare.
When asked an open-ended question regarding the benefits they anticipated from statehood, just below one-third cited potential healthcare advancements.
However, the insufficient funding of healthcare programs in Puerto Rico because of its present territorial status significantly impacts the well-being of its inhabitants. Improvements to Puerto Rico’s health system that could be achieved through enhanced funding and associated resources, made feasible by aligning program standards closer to those in U.S. states, could result in substantial advancements in health outcomes for Puerto Ricans.
Inadequate federal Medicaid funding
Puerto Rico receives far less federal funding for Medicaid compared to U.S. states despite having a higher poverty rate. This leads to lower reimbursement rates for healthcare providers, a diminished healthcare infrastructure, and restricted access to services for residents.
Medicaid in U.S. states adapts to patient requirements. Conversely, the program functions differently in Puerto Rico. Rather than open-ended funding based on needs, Puerto Rico’s territorial government receives a grant with a strict limit. This amount is insufficient to meet the needs of eligible individuals in Puerto Rico. Consequently, Medicaid beneficiaries in Puerto Rico receive fewer benefits compared to those in the states. When funds are depleted, no additional Medicaid resources are available, irrespective of patient needs.
Medicare disparities
Medicare is a federal initiative aimed at individuals aged 65 and above, as well as younger individuals with end-stage kidney disease. Eligibility does not hinge on financial criteria.
While Puerto Rico is part of Medicare and its residents pay Medicare taxes, there are significant distinctions in how the program is executed in the U.S. territory. For starters, enrollment for medical services under Part B of Medicare is automatic in the states upon reaching 65, but beneficiaries in Puerto Rico must take the initiative to enroll. Late enrollment incurs substantial financial penalties, which accumulate over time.
Moreover, physician reimbursements in Puerto Rico are a fraction of those in the states, and Medicare Advantage—more prevalent in Puerto Rico than in the states—pays only about 40% of the rates in the states. In a 2022 letter to U.S. Secretary of Health and Human Services Javier Becerra, several Members of Congress expressed concern regarding these disparities in Puerto Rico’s Medicare program.
“Puerto Ricans pay the same Medicare payroll tax as mainland Americans,” highlights the Medicaid and Medicare Advantage Products Association of Puerto Rico (MMAPA) on its website, “Yet, Medicare beneficiaries in Puerto Rico receive the lowest federal Medicare spending per enrolee in the nation.”
Inadequate representation
Puerto Rico has only a non-voting representative in the U.S. House of Representatives, which restricts its direct influence on national healthcare policies. This lack of representation also impacts the total grant funding and other federal resources allocated for healthcare in Puerto Rico. Currently, Resident Commissioner Jenniffer Gonzalez-Colon does not serve on any health-related committees, further narrowing Puerto Rico’s voice in national health matters, and there are no Senators from Puerto Rico. With enhanced representation in Washington, Puerto Rico could have a stake in all critical committees overseeing related issues.
Exodus of healthcare professionals
A significant number of healthcare workers leave Puerto Rico due to economic challenges and limited prospects, exacerbating the strain on the healthcare system. 72 out of Puerto Rico’s 78 municipalities are officially deemed underserved.
Even in the states, many physicians limit the volume of Medicare and Medicaid patients they accept due to low reimbursement rates and extensive paperwork. In Puerto Rico, where reimbursement rates are even lower and half the population relies on Medicaid (with another 11% on Medicare or veteran benefits), physicians face challenges to thrive.
The consequences of territorial status
Recent studies have shown that mortality rates in Puerto Rico have remained alarmingly high even after the COVID-19 pandemic subsided. Chronic diseases are widespread. Remaining a territory is likely to hinder solutions for these issues, most of which have persisted for decades. All these are direct consequences of territorial status.
It is impossible to predict how independence would influence healthcare in Puerto Rico, as the nature of governance in a new Puerto Rican nation is uncertain. However, statehood would guarantee equal federal funding, enhanced infrastructure, a comprehensive voice in American governance, and full protection under the U.S. Constitution.
If only 32% of survey respondents anticipated that statehood would result in healthcare improvements, it suggests that the group may have underestimated the potential effects.
The post Poll Reveals Puerto Ricans Might Underappreciate Healthcare Consequences of Political Status appeared first on PUERTO RICO REPORT.
