/ Wednesday, October 6, 2021
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Puerto Rico ‘Mi Salud’ Gets Funds Extension Until Next Year V2A report: Challenges remain ahead
O Rosario Fajardo
rfajardo@wjournalpr.com
@RosarioWJournal
nce again, Puerto Rico’s much feared Medicaid fiscal cliff will not occur. As expected, the Puerto Rico Health Department has received the requested allocation of $2.9 billion for the island’s Medicaid plan known as “Mi Salud” in Spanish for the medically indigent. “For Puerto Rico, this allocation is extremely important because it will allow us to continue offering the health services received by the over 1.5 million people in Puerto Rico through Medicaid and the Vital Plan, especially in times of the health emergency caused by COVID-19,” said Gov. Pedro R. Pierluisi. The allocation from the Center for Medicare & Medicaid Services (CMS) went into effect on Oct. 1. technological projects, process optimizations and and will be extended through 2022. avoidance of fraud and waste of public funds. An “We want all Medicaid and Vital Plan increase in Medicaid expenditures per beneficiary beneficiaries to be reassured that their services does not entail greater access or services through will not be affected. These new funds will have a positive impact on the services we offer and that is its manage care programs as it aims to fill gaps and not exceed them,” said the good news because it is about report, authored by Guillermo guaranteeing the right that we Guasp, senior associate, all have to health,” said Health and Griselle Bigio, senior Secretary Carlos Mellado. engagement manager, both at Regardless of the good V2A. news, a report by V2A The authors point out Consulting points to continuing The funding issue must that currently, legislation challenges ahead. “All things be addressed, the V2A includes implementing a set considered; Congress acted report points out, as of checks and balances to to secure funding in the near almost half of Puerto address concerns from the short-term outlook but opted Rico’s population get Federal Government over for not making this funding their healthcare coverage inferences of misuse of federal permanent and extensive for through the Medicaid funds. “Even though such Puerto Rico. Furthermore, it program and [they] are checks and balances could postponed the discussion of part of the indigent pose short-term obstacles, appropriating equal funding in population with fewer the program’s stakeholders comparison with other States. purchasing power to could benefit from focusing Yet, the current proposal acquire individual health on the underlying longdoesn’t consider system and coverage.” term challenges that remain infrastructure changes needed unaddressed. A solid to provide greater access and partnership between Puerto quality of care for program Rico’s government and the Health Sector is vital recipients. to continue supporting ongoing lobbying efforts “On numerous occasions the Federal and provide a long-term solution to these funding Government has called upon Puerto Rico to gaps as well as allocate resources to renovate the transform its infrastructure through special
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island’s health infrastructure,” they wrote. The V2A report points out that under federal law, Medicaid funds assigned to Puerto Rico are allocated through a yearly statute, which does not include special appropriations approved by Congress to account for increase in Medicaid funding needs. “Usually, these increases in Medicaid funding needs create a funding gap that forces Puerto Rico to request larger amounts each year to cover 1) increases in program beneficiaries and 2) higher utilization rates or service costs.” The authors also note that Puerto Rico would be eligible for a higher share of federal funds to cover an increase in services and eligible population if it were treated as a state. “However, Puerto Rico as a territory of the United States has a capped annual allotment, which represented $366.7 million dollars in FY2019. This means that regardless of the number of beneficiaries, or any increase in services provided to the island’s indigent community, expected funding appropriations remain untouched. This allotment represented 14 percent of the total appropriated federal funds to cover Medicaid costs in said year.” The funding issue must be addressed, they pointed out, as almost half of Puerto Rico’s population get their healthcare coverage through the Medicaid program and [they] are part of the indigent population with fewer purchasing power to acquire individual health coverage.”
