October 12, 2017

Unless Congress Acts to Prevent the Collapse of Puerto Rico's Medicaid Program, Millions in Additional Costs Will Shift to Florida

This post was last updated on December 8, 2021. As new policies are announced, FPI will update this page.

As Florida’s response to COVID-19 takes front and center, concern grows for low-income families who struggle to take precautions against the spread of the virus. Although Congress has passed the Families First Coronavirus Response Act to address, at least in part,  the public health crisis and economic fallout from COVID-19, many barriers continue to keep struggling families from accessing the assistance they need during the pandemic. As Florida initiates policies implementing the Act and addressing other barriers to the safety net, FPI will update this form. When available, hyperlinks are provided to agency documents or statements that provide greater detail  about the new policy.

On March 22, 2020, FPI and 44 other organizations sent a letter to Governor DeSantis, leadership in the Legislature and agency heads to urge action on 47 specific policy changes to reduce unnecessary barriers for Florida’s safety net programs in response to the COVID-19 pandemic. See the letter here.

The devastating impact of Hurricane Maria is bringing Puerto Rico’s Medicaid funding crisis to a head. Over 40 percent of Puerto Ricans are covered by Medicaid. For years, the program has been severely underfunded due to a hard cap on Puerto Rico’s federal Medicaid funding. Enormous costs have subsequently shifted to the Puerto Rican government, contributing to its deepening fiscal crisis.

A new report from the Center for Economic and Policy Research concludes that unless Congress acts quickly to change Puerto Rico’s Medicaid funding model, both federal and state Medicaid budgets will incur billions more in costs. Thousands of Puerto Ricans will be forced to relocate stateside to get the health care they need, and this health care is significantly more expensive.  Since Florida is the most popular destination for Puerto Rican relocation, the state will bear a disproportionate amount of these costs.

Medicaid costs would be substantially less for both the federal and state government if Congress would fund Puerto Rico’s Medicaid program the same way it funds the states– through open-ended federal funding, which increases in times of disasters and higher needs.

Puerto Rico’s Medicaid program is the poster child for the pitfalls of capped federal Medicaid funding. It’s a cautionary tale that cannot be ignored as troubling national proposals for capped Medicaid funding continue to circulate.

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