Dem rips disaster package for failing to address Medicaid in Puerto Rico, Virgin Islands

A top Democratic lawmaker on Tuesday ripped the House’s disaster funding package for failing to include any provisions helping Medicaid programs for Puerto Rico and the U.S. Virgin Islands.

“It’s disgraceful that the House Republican’s emergency supplemental funding package does absolutely nothing for the more than 1.6 million Americans in Puerto Rico and the U.S. Virgin Islands that are counting on Medicaid in the wake of overwhelming devastation,” said Rep. Frank Pallone Jr. (N.J.), the top Democrat on the House Energy and Commerce Committee.

House Republicans are preparing to attach an $81 billion disaster aid package to a stopgap government spending bill aimed at keeping the government open past Friday. The supplemental package includes money to fund hurricane and wildfire relief efforts.

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Hurricane Maria caused serious damage to the health-care system in the U.S. territories, but none of the federal disaster relief money to date has been earmarked for Medicaid.

The amount is nearly double the $44 billion the White House proposed last month, but still falls short of the $94 billion requested by Puerto Rico.

On Monday, Rep. Nita Lowey (N.Y.), the ranking Democrat on the House Appropriations Committee, said the supplemental package “is not the product of bipartisan negotiation and compromise.”

Lowey said the package doesn’t include Democratic priorities, like addressing Puerto Rico’s Medicaid shortfall. Medicaid programs in the territories are expected to exhaust current funds in early 2018 without emergency funding.

Democrats had requested $4.9 billion over two years, as well as a 100 percent federal match for that period, for Puerto Rico. They asked for $150 million over two years for the Virgin Islands.

Pallone urged lawmakers to provide additional aid.

“Congress must lift the Medicaid cap, give a 100 percent funding match to Puerto Rico and the U.S. Virgin Islands, and ensure all evacuees receive the care they need,” he said.

As a result of a funding cap set by Congress decades ago, Puerto Rico effectively receives less than 20 percent in reimbursements for Medicaid. If it were treated as a state, its reimbursement rate would be 83 percent.

Puerto Rico is subject to a hard cap of about $300 million a year. If the island’s government spends more than that amount, it must cover the cost.

Experts say the formula has forced the Puerto Rican government to cover a large portion of the costs from its own budget, contributing to the island’s debt crisis.  

Rep. Tom Cole (R-Okla.), a top House appropriator, told reporters the disaster funding doesn’t address all the health-care issues facing the territories because it’s meant for emergency aid only and is primarily aimed at helping displaced residents.

“I’m not saying that’s something that couldn’t come later, but this is still emergency relief and it’s supporting a pretty fragile health-care system, and then trying to support people who’ve been displaced through no fault of their own,” Cole said.

The stopgap spending bill does contain $1 billion to help address Puerto Rico’s impending Medicaid cliff, but it was included as part of a provision reauthorizing the Children’s Health Insurance Program that’s likely to be changed in the Senate.