Washington D. C. - In the next few days, when the U.S. Congress leadership introduces the continuing resolutions to extend current year funding, the Federal Medical Assistance Percentage (FMAP) for Puerto Rico may only be extended for three days.
According to the executive president of the Puerto Rico Hospital Association Jaime Plá, the plan is still to leave any agreement seeking a long-term solution to Medicaid funding for the island -which largely funds the Puerto Rico government’s health plan- for the end of the year, when the spending package, known as omnibus, is expected to be approved.
Plá held meetings this week with members of the U.S. House Energy and Commerce Committee and officials of the Senate Finance Committee, which oversees the Medicaid program. The meetings included Senator Rick Scott (Fla.), and US House representatives such as Puerto Rican Democrat Darren Soto (Fla.), and Republicans Brett Guthrie (Ky.), Gus Bilirakis (Fla.), and Kat Cammack (Fla.), among others.
Without a new law, the FMAP would drop on December 13 from 76 percent to 55 percent - according to the permanent statute - costing the Puerto Rico treasury more than $500 million annually.
The continuing budget resolution - aimed at avoiding a partial government shutdown on October 1, when the new fiscal year begins - may extend federal government spending until December 16, when the idea is to have reached a general agreement on fiscal year 2023 spending.
So this month, the resolution can only extend FMAP from December 13 through 16, Plá said.
At the end of Thursday’s meetings, Plá pointed out, however, that “there is a consensus to resolve long-term funding.” But, differences over the amount remain amid Republican criticism of the Joe Biden administration’s executive order that interpreted a December 2019 law as securing Puerto Rico nearly $3 billion annually.
On the Republican side, some have been insisting on establishing mechanisms to oversee the use of the funds.
Plá told Congress members that “a good starting point” would be a five-year agreement that revives the language of the “Build Back Better” budget reconciliation bill that the House passed in November 2021, which would guarantee $3.6 billion annually, an 83 percent FMAP and an increase in funding based on rising health care costs.
During the COVID-19 pandemic, the federal government increased Medicaid appropriations by 6 percent.
Plá insisted that the bill the Energy and Commerce Committee passed in the summer of 2021 would mean “going backward.” That bipartisan agreement would have represented $2.809 billion during this federal fiscal year 2022, and $2.719 billion between 2023 and 2026. Another $200 million depended on 70 percent of the funds going to health care providers.