President Joe Biden supports Puerto Rico’s full access to those programs, but any proposal on that must emerge from the U.S. House and Senate.
Thursday, June 3, 2021 – 9:52 a.m.
By José A. Delgado Robles
Washington D. C. – The idea of getting Puerto Rico on track for parity in Medicaid, Supplemental Security Income (SSI), and nutrition assistance – which could have a short-term impact of at least $4.6 billion annually – will have to be worked through five congressional committees.
Congress is expected to urgently address Medicaid funding because Puerto Rico’s healthcare industry may fall into a fiscal cliff without new funding approved for federal fiscal year 2022, which begins October 1. But, Puerto Rico’s access to SSI and the Supplemental Nutrition Assistance Program (SNAP) – like the states – may have a slower path during this term, if they get the go-ahead from Congress.
Last Friday, President Joe Biden sent his budget bill to Congress supporting. The elimination of Medicaid funding caps for Puerto Rico and moving toward parity in SSI and Nutrition Assistance. But, the whole process will depend on what Congress, with a Senate particularly divided 50-50, wants to do.
“Biden expressed his support for those proposals but did not make formal recommendations to Congress,” warned a source close to Puerto Rico issues in Washington, stressing that there are no appropriations for those initiatives among the proposals the White House sent to Senate and House committees.
In the House, Medicaid is under the jurisdiction of the Committee on Energy and Commerce, whose chairman, Democrat Frank Pallone (N.J.) supported yesterday the idea of giving the island parity in Medicaid. “Puerto Rico’s Medicaid program should be treated like the states and receive the level of federal funding it deserves. The current funding structure is unfair and inadequate, and Puerto Rico needs a permanent and reliable solution that generates certainty for years to come,” Pallone told El Nuevo Día yesterday.
A subcommittee of the Energy and Commerce Committee has already held a hearing on the territories’ access to Medicaid, and Democrats are expected to help at least avoid a fiscal cliff that would affect patients under the Puerto Rico government’s “Vital” health plan, which receives about $2.842 billion this federal fiscal year.
In the Senate, the Finance Committee addresses Medicaid issues. This committee chairman, Democrat Ron Wyden (Ore.) has been saying since January that he will advocate for Puerto Rico’s Medicaid program to have the resources it needs and deserves. Under the fiscal plan proposed by Governor Pedro Pierluisi, Medicaid appropriations, on the way to parity, are expected to be around $4.174 billion in fiscal year 2022,
The task force created by the governor estimates that with a federal contribution of 83 percent for Medicaid services – instead of the current 55 percent – Puerto Rico could receive a total of $5.2 billion annually. This, according to the Hospitals Association president, Jaime Plá, indicating that the island’s government would have to contribute another $800 million.
The Fiscal Board overseeing Puerto Rico’s public finances has avoided projecting a new Medicaid allocation until it is approved. It has only estimated the $400 million that the island receives through permanent law.
As for the SSI, the CNE has estimated that the impact of that program – based on eligibility standards – could represent about $2.58 billion annually and benefit up to 435,000 people.
The SSI is intended to assist people who are 65 or older, are “disabled” or blind, and have low or no income. It provides funds to meet their basic needs for food, clothing, and shelter.
In the House, SSI is under the jurisdiction of the Ways and Means Committee. In the Senate, the issue is also addressed by the Finance Committee.
Torres believes that Congress may wait to see what happens with the Vaello Madero case before the U.S. Supreme Court, in which the Biden administration is challenging the decision by the First Circuit Court of Appeals that opened the door for island residents to access SSI. That case may be resolved next fall.
The CNE director in Washington, meanwhile, thinks that getting nutrition assistance parity on track may have to wait until 2023 when Congress will have to reauthorize the federal farm bill and then will have to reexamine the SNAP program.