Washington - Amid negotiations with the House, the Republican Senate leadership proposed a $9.814 million allocation in Medicaid funds for Puerto Rico over the next four federal fiscal years.
The proposal by Senate Finance Committee Chairman Charles Grassley, a Republican from Iowa - represents about $2.2 billion less than the $12 billion in the bill the House Energy and Commerce Committee approved last July for the same period.
Following recent corruption charges involving the operation of the Puerto Rican government's health plan, Grassley's draft legislation - to which El Nuevo Día had access and that was first published by Reorg America - tightens language on controls over Medicaid on the island, compared to the bill approved by the House Energy and Commerce Committee last July. For example, it proposes annual forensic audits.
In percentage terms, Grassley suggests a 70 percent federal contribution for Medicaid services in Puerto Rico, while the House bill proposes a minimum of 76 percent, higher than the current 55 percent. The House version would authorize an 83 percent for the first two years, a percentage that Grassley's proposal still recommends for the other territories.
According to the proposal, failing to comply with the audit requirement would allow reducing federal funding for Medicaid back to 55 percent.
It would ensure Puerto Rico allocations of $2.381 million, $2.429 million, $2.477 million, and $2.527 million for fiscal years 2020, 2021, 2022, and 2023. The House bill represents an average of $3 billion annually.
Although the allocation is smaller than that of the House bill, allocations in Grassley's proposal would still be higher than those previous to Hurricane María.
For example, until fiscal year 2017, federal allocations for Puerto Rico's health plan, including permanent law funds, were about $1.6 billion annually. They increased, however, as of fiscal year 2018, because - after the catastrophe caused by Hurricane María - Congress authorized a $4.8 billion emergency allocation which until Nov. 21 fully covers the cost of Medicaid services on the island.
Grassley's aides –the senator said the federal government must ensure the proper use of Medicaid funds on the island- have been in conversations with House Energy and Commerce Committee officials seeking to reach an agreement by Nov. 21, when the temporary resolution to fund the federal government expires.
However, the Puerto Rican government, in a response from the Federal Affairs Administration (PRFAA), warned the Finance Committee that a $9.8 billion allocation over the next four federal fiscal years would not be enough to implement essential measures that are necessary to improve health care services for the people of Puerto Rico and expand coverage under Medicaid.