Puerto Rico Resident Commissioner Pablo José Hernández has re-introduced the TRICARE Equality Act. The legislative proposal, also introduced by Jenniffer Gonzalez-Colon in 2021 and then again in 2023, seeks to improve health benefits available to veterans living in Puerto Rico. Cosponsors of the 2025 bill include House Veterans Affairs Health Subcommittee lead Democrat Rep. Julia Brownley (CA), as well as Reps. Eleanor Holmes Norton (D-DC), and Hank Johnson (D-GA).
“Our veterans and military families in Puerto Rico have sacrificed just as much as their counterparts on the mainland, and they deserve equal access to the healthcare benefits they’ve earned,” said Hernández.
“The TRICARE Equality Act will help close the unacceptable gaps in care faced by our servicemembers, retirees, and their families on the island. By improving TRICARE Prime access, expanding travel benefits, and ensuring better coordination of health data, this bill takes a critical step toward treating Puerto Rico’s military community with the dignity and fairness they deserve.”
What is TRICARE?
TRICARE is the health program for members of the U.S. military, veterans, and their families. In Puerto Rico, it is administered through the TRICARE Overseas Program. Unfortunately, the benefits for residents of Puerto Rico do not match those in the states. Veterans on the Island often must pay for services upfront and wait for reimbursement, or even travel to a state for medical services.
Of particular interest is TRICARE Prime, a managed care option within the TRICARE health care program, primarily available in specific Prime Service Areas (PSAs). Prime members are assigned a Primary Care Manager (PCM) who coordinates most of their healthcare. Out of pocket costs are lower with Prime, and travel benefits cover the cost of travel to military healthcare facilities. The TRICARE Overseas Program is similar, but not equal to the Prime benefits.
What does the TRICARE Equality Act provide?
The TRICARE Equality Act calls for PSAs to be established in Puerto Rico as they are in the states — on the basis of the proximity of military medical care facilities such as those at Ft. Buchanan. It also calls for service members, veterans, and their families to have travel benefits as they would if they lived in a state.
The bill also mandates coordination between the Federal Electronic Health Record Modernization Office and the Department of Health of Puerto Rico to share health information through the Joint Health Information Exchange.
Why is there inequity?
The Supreme Court has repeatedly ruled that Congress can treat territories differently from states, and the differences in veterans’ benefits are examples of this freedom. Although Puerto Rican veterans can access the full range of U.S. Veterans Affairs (VA) benefits if they are living stateside, VA benefits for veterans living in the U.S. territory are less generous.
It’s worth noting that when the Philippines gained independence from the United States, veterans who had fought in the U.S. military lost their veterans’ benefits. Similarly, veterans of the U.S. military living in the U.S. freely associated states (FAS) of Palau, the Marshall Islands and Federated States of Micronesia were legally excluded from receiving VA healthcare in the FAS until last year; although veterans’ healthcare is now authorized within their borders, the programs have yet to be implemented.
These facts are in contrast to the optimistic ideas of separatists who claim that veterans would continue to receive their health benefits if Puerto Rico were to become a sovereign nation, or the small but vocal group of independence supporters living stateside who do not need to worry about the practical implications for U.S. veterans in Puerto Rico if the U.S.-Puerto Rico connection is severed.
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