From The Star Team
According to Robert Mujica, Executive Director of the Financial Oversight and Management Board, Puerto Rico’s healthcare system is facing potential instability beginning in 2028, when federal funding for the Medicaid program reverts to pre-Federal Consolidated Appropriations Act levels.
Mujica remarked, “The decrease in funding poses a significant threat to the long-term stability of healthcare financing for almost half the population [of Puerto Rico] and could further disrupt the healthcare system across Puerto Rico.”
He highlighted that Puerto Rico will receive upwards of $19 billion in Medicaid revenue under the Consolidated Appropriations Act between 2023 and 2027. However, beginning September 2027, Medicaid funding will revert to legally set levels unless new legislation is passed by the U.S. Congress to extend the Act or enact new regulations on the topic.
Mujica expressed that his vision for Puerto Rico’s health system is “a straightforward one,” aimed at ensuring “each resident gets the care they require.” Nonetheless, he conceded that realizing this goal is far more complex than just articulating it, pointing out financing and information deficits as significant hurdles.
“We require data to outline the transformation and the essential steps to be taken,” Mujica stated. “Regarding financing, the board has sanctioned increased payments to Medicaid management organizations, expanded access to medical services, and uplifted payments to health service providers.
He emphasized that these measures equate to a $35 million investment this year, and more than $100 million over the following three years.
He also indicated that the oversight board raised the eligibility thresholds for Puerto Rico’s Medicaid program based on the federal poverty line.
While acknowledging that these and other funding initiatives are “crucial funding efforts,” he mentioned that annually there are certain areas where the oversight board “must decline.”
