Mandated Report: Medicaid in Puerto Rico

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October 2018

Puerto Rico is the oldest and most populous United States territory. The island’s present-day Medicaid program, the Government Health Insurance Plan, was established in 1993. Puerto Rico’s Medicaid program—along with its health system in general—has faced substantial challenges even before Hurricane Maria struck in 2017, including fiscal problems due to Puerto Rico’s capped Medicaid allotment; access issues due to outmigration of health professionals; and weaknesses in its health care infrastructure.

In the report accompanying fiscal year 2019 Labor, Health and Human Services, and Education appropriations (P.L. 115-245), the House Committee on Appropriations asked MACPAC to examine options for ensuring long-term sustainable access to health care for Medicaid beneficiaries in Puerto Rico. As a first step in developing this analysis, this presentation provides background information on Puerto Rico and an overview of its Medicaid program.

Publication Type: Presentations

From: October 2018 MACPAC Public Meeting

Tags: access, benefits, eligibility, Federal Medical Assistance Percentage (FMAP), federal/state partnership, financing, program integrity, spending