WASHINGTON - While Medicaid funds are running out, local authorities seem unable to agree on the use of existing resources.
The Puerto Rico Health Insurance Administration (PRHIA) indicated that Medicaid funds - which largely finance the Puerto Rican government's health plan - will last until March.
However, the Puerto Rico Federal Affairs Administration (PRFAA) said a few days ago that the government should have sufficient federal funds until early February 2020 and they have taken that message to other sources in Washington D.C.
In the same written response, PRFAA Executive Director Jennifer Storipan said that the Puerto Rican government may have to fund the health plan with its own funds starting mid-February or early March. However, she stressed that the government has enough funds in the Treasury to finance the health plan - Vital - through June when the local fiscal year ends.
While Puerto Rican authorities are requesting new funds- which will come with strict oversight measures following last summer's corruption cases - discrepancies over how the health plan will be financed are not limited to information provided by Wanda Vázquez Garced's administration.
The Oversight Board recently told El Nuevo Día that the Puerto Rican government has $864 million in assigned funds in the General Fund and $360 million of "own income" to finance the health plan, for a total of $1.224 billion.
However, PRHIA says it's $1.235 billion and according to this agency, funds approved by the Board total $1.05 billion and the government's "own income" reaches $230 million.
The allocation of local funds for the health plan was made considering that Medicaid services could be federally funded at 100 percent through September 30.
Under permanent law, the government of Puerto Rico has to fund 45 percent of the cost of Medicaid services offered through the local health plan. But after the catastrophe caused by Hurricane María, the federal government has temporarily funded 100 percent of Medicaid services on the island.
That percentage will continue until December 20, according to the temporary spending resolution signed on November 21.
According to PRHIA current deputy director Yolanda García, between July and October, the Puerto Rican government allocated $919.8 million to the health plan. Of that package, $639.58 million were federal funds, $225.7 million were state allocations, and $54.5 million came from other sources that were not defined in her written response to this newspaper.
According to data by PRHIA, funds from the General Fund has been used at a rate of $56.4 million monthly.
If Medicaid is no longer fully funded by December 20, PRHIA should still have at least $700 million in federal funds for the second part of the Puerto Rican fiscal year, that is, from January through June.
That package would include some $375 million in Medicaid funds allocated by permanent law and which have not been used because the $4.8 billion allocated as emergency funds in February 2018 after Hurricane María are still available, and the remaining $586 million through the federal Obamacare law, which largely finance the Puerto Rico government's health plan since October 1.
PRHIA estimates that if it could use, up to December 31 - when funds expire - 100 percent of the Medicaid funds provided by the Obamacare law, it would still leave some $40 million left.
In addition to the $375 million in Medicaid funds allocated to the island by permanent law, the Puerto Rican government's health plan has $86.2 million from the federal Children's Health Insurance Program (CHIP) and $59.37 million from the Enhanced Allotment Plan (EAP), which helps finance medicine for the most vulnerable.
PRHIA said that CHIP and EAP funds must be used monthly "according to the specific population" in the Puerto Rican government's health plan, which currently costs $239 million monthly.