Pablo José Hernández, Resident Commissioner of Puerto Rico, has formally submitted his recommendations to the Puerto Rico Health Insurance Administration (ASES) for the report being prepared by the governor’s working group addressing the upcoming Medicaid fiscal cliff. Hernández stressed the importance of complying with statutory requirements set in 2023 and highlighted bipartisan and multisectoral collaboration as essential to address the Medicaid funding shortfall expected in September 2027.
In his recommendations, Hernández noted that funds secured in 2023 benefit about 1.5 million Puerto Ricans and must not be lost. He emphasized that it is crucial for the Puerto Rican government to provide clear evidence of the positive impact these funds have had.
“When interacting with leaders from both chambers and both parties, we must base our case on reliable, updated, and consistent data. Providing members of the House and Senate with clear evidence of how increased funding has expanded coverage and improved healthcare quality and quality of life for Puerto Ricans will be crucial to ensure long-term stability and parity,” said Hernández.
He also underlined the need for government compliance with legal requirements established in 2023. These include implementing an asset verification system and submitting an annual report to Congress describing how Puerto Rico has increased access to health services using additional funds and higher FMAP rates.
To this end, Hernández insisted that “the Puerto Rico Department of Health must collect data supporting Puerto Rico’s case for Medicaid parity, including evidence of full compliance with legally established requirements, and share them with organizations participating in this committee.”
His report also includes concerns raised by physicians and other professionals who were not part of the working group, such as the College of Physicians and the Fiscal Oversight Board. These groups pointed out delays in payments, claim denials, and a lack of effective oversight—issues that directly affect patient care.
Finally, Hernández highlighted his discussions with congressional leadership regarding the fiscal cliff issue and noted a positive response “to the example of bipartisanship our offices have established.” He reiterated his intention to continue collaborating with the governor on this urgent matter.
The full letter can be viewed HERE.
