The Impact of the Puerto Rico Debt Crisis on Its Medicaid Beneficiaries

The economic crisis in Puerto Rico created its current health crisis. The Medicaid crisis was exacerbated by Puerto Rico’s decision to expand eligibility for the program when the funding increase was only temporary. Obligations of permanent expenditure increases should never be made when financed by non-permanent funds. Further, Puerto Rico’s funding cap is tied to the CPI-U, a measure of national inflation, which may not track well with the inflation rate experienced by residents of the island. Medicaid block grant and per capita allotment proposals would not place states under a territory-like financing structure.

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