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U.S. Congress introduces $14B Medicaid parity bill for P.R., U.S. territories

U.S. Congressman Darren Soto introduced bipartisan legislation to provide equal access to federal resources for Medicaid to American citizens living in U.S. territories, the lawmaker’s office announced. 

H.R. 3631, known as the Territories Health Care Improvement Act, increases the limit on Medicaid payments and the federal medical assistance percentage for the five U.S. territories: Puerto Rico, U.S. Virgin Islands, Guam, American Samoa, and Northern Mariana Islands. It also sets stipulations to implement integrity and reporting measures for the programs.

“As we continue our efforts to provide affordable health care for all Americans and work to protect the Affordable Care Act, we must also act on parity of health care between American citizens in the mainland and those in U.S territories,” said Soto.

“Under the current archaic system, unequal access to federal resources puts a strain on the territories’ Medicaid programs, especially areas with ongoing health care crises exacerbated by hurricanes,” the lawmaker said.

“Our plan ensures families have continued access to health care while immediately relieving financial pressures on the territories. Every American citizen deserves equal access to Medicaid coverage,” he added.

The legislation provides a path away from capped federal funds for Medicaid program to several years of increased allotments, totaling $12 billion for Puerto Rico, $762 million for Guam, $756 million for USVI, $504 million for American Samoa, and $360 million for Northern Marianas.

It also implements important program integrity provisions, including a new asset verification system and payment error rate measurements, both already required for state Medicaid programs. All territories will also need to report annually to Congress on the expenditures of increased Medicaid funds.

The Territories Health Care Improvement Act creates a new funding structure increasing the matching rate Federal Medical Assistance percentage (FMAP):

  • Puerto Rico: 83% for the first two years of additional funds, and 76% for the final two years.
  • Guam, American Samoa, and CNMI: 100% for two years, 83% for three years, and 76% for one year.
  • U.S. Virgin Islands: 100% for one year, 83% for four years, and 75% for one year. 

The bipartisan legislation was co-introduced by Soto (FL-09), Rep. Gus Bilirakis (FL-12), Jenniffer González-Colón (R-Puerto Rico), and co-sponsored by: Nydia Velazquez (D-NY), Michael San Nicolas (D-Guam), Stacey Plaskett (D-U.S. Virgin Islands), Gregorio Kilili Camacho Sablan (I-Islas Marianas), Aumua Amata Coleman Radewagen (R-American Samoa), Jose Serrano (D-NY), Raul Grijalva (D-AZ), Brian Fitzpatrick (R-PA), and Peter King (R-NY).

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This story was written by our staff based on a press release.

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