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Coalition asks Congress to address Medicaid funding shortfall in U.S. territories

June 21, 2019

By Kimber Solana

Washington — The Partnership for Medicaid is asking legislators to address a pending Medicaid fiscal cliff that could affect patients and providers in U.S. territories, including American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands.

In a June 20 letter, the coalition — which includes the ADA — asked leaders of the House and Senate to address the cliff before the Sept. 30 deadline.

Because federal medical assistance percentage for Medicaid payments to U.S. territories are statutorily prescribed and don't take into consideration per capita income, Medicaid programs in the territories are underfunded compared to their state counterparts, according to the letter, sent to leaders in both chambers.

"Temporary Medicaid funds from the Affordable Care Act and subsequent legislation in 2017 and 2018 provided critical health care support in the territories, but the vast majority of these funds expire at the end of this fiscal year," the letter said.

Without additional funds to offset the end of the temporary federal Medicaid funds, the impact to the territories' budgets, coverage and patients' health "will be severe," the coalition wrote.

Nearly half of Puerto Rico's 3.2 million residents receive health coverage through Medicaid. According to the letter, without additional funds, Puerto Rico's federal Medicaid funding would be capped at $380 million, a fifth of the funding needed for fiscal year 2020.

"We urge Congress to act ahead of the Sept. 30 deadline to address the pending Medicaid fiscal cliff," the coalition concluded in its letter. "We encourage both chambers to come together to address the short-term and long-term Medicaid financing challenges in the territories."