Text of Bill (PDF) | Section-by-Section Summary (PDF)

 

Washington, DC – United States Senator Elizabeth Warren (D-Mass.) joined Senator Bernie Sanders (I-Vt.), along with six other cosponsors in the Senate, to introduce legislation Tuesday to address immediate humanitarian needs in the territories, including Puerto Rico and the U.S. Virgin Islands.

 

The Territories Health Equity Act of 2019 (S. 1773) would correct long-standing inequities in federal health care funding for Medicaid and Medicare, and give the nearly four million Americans living in the U.S. territories of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands access to the health care they need. The bill is cosponsored in the Senate by Senators Jeff Merkley (D-Ore.), Kirsten Gillibrand (D-N.Y.), Richard Blumenthal (D-Conn.), Kamala Harris (D-Calif.), Cory Booker (D-N.J.), and Edward J. Markey (D-Mass.). Representative Stacey Plaskett (D-V.I.) introduced the companion bill (H.R.1354) together with 37 cosponsors in the House. The Senate version of the bill is endorsed by the American Federation of Teachers, Latinos for Healthcare Equity, BoricuActivate, Boricuas Unidos en la Diaspora (BUDPR), and the International Association of Machinists & Aerospace Workers Union.

 

Over a year and a half after Hurricane Maria, much of Puerto Rico and the U.S. Virgin Islands remain devastated. The vast majority of residents in Puerto Rico -- a full 85 percent -- report they are worried they will be unable to access health care if they need it. Nearly one in four people living in Puerto Rico report they or a family member have developed a new or worsened health condition as a result of Hurricane Maria, and one in three report they or someone in their home have experienced trouble accessing medical care. Similarly, in the face of an increased demand for services, the U.S. Virgin Islands has been unable to spend the Medicaid dollars required to secure federal matching funds.

 

Temporary Medicaid funding for Puerto Rico and the U.S. Virgin Islands expires in September. This funding cliff could be disastrous for the more than 1.5 million people covered by the program. In Puerto Rico alone, an estimated 900,000 people could lose coverage.

 

The legislation introduced today would provide the territories with the same type of Medicaid funding that is currently available to the fifty states and the District of Columbia by eliminating the arbitrary cap on annual federal Medicaid funding and increasing the federal matching rate for the territories’ Medicaid expenditures. The bill would also address Medicare disparities by updating hospital reimbursements and increasing funding for the territories to provide prescription drug coverage to low-income seniors.

 

In 2017, after the hurricanes, Senators Sanders and Warren authored a “Marshall Plan” for Puerto Rico and the U.S. Virgin Islands. This far-reaching legislation included parity for Medicaid and Medicare for the territories. Senator Warren also joined colleagues in late 2017 in urging Senate leadership to bolster the territories’ Medicaid programs in the wake of the hurricanes.

 

"Families in Puerto Rico, the U.S. Virgin Islands, and other territories deserve access to the same federal health care programs as families throughout the rest of the United States—no exceptions,” said Senator Warren. “We are introducing the Territories Health Equity Act to end discriminatory double standards in the way Medicare and Medicaid are administered in the U.S. territories."

 

“It is unconscionable that in the wealthiest nation in the world we have allowed our fellow citizens to suffer for so long. The full resources of the United States must be brought to bear on this crisis, for as long as is necessary,” said Senator Sanders. “We must go forward to ensure a strong health care system in all the territories and address inequities in federal law that have allowed the territories to fall behind in almost every measurable social and economic criteria.”

 

"I would like to thank Senator Sanders for introducing the Senate companion bill to H.R. 1354, Territorial Health Equity Act of 2019. Both bills make improvements to the treatment of the United States territories under the Medicare and Medicaid programs. I am appreciative that Senator Sanders continues to support on matters that are critical to the well-being of residents in the U.S. territories," Rep. Plaskett said.

 

“As co-sponsors of the House version of this Bill we are excited to have Senator Sanders joining us in the fight for Territorial healthcare equality. These measures will bring much needed parity in the Medicaid funding levels for Guam and relieve a legacy pressure point that has been choking our healthcare budgets for decades,” said Delegate Michael F.Q. San Nicolas (D-GU-At Large).

 

“More than 3,000 U.S. citizens died in the wake of Hurricane Maria, largely due to the incompetence and delay of President Trump’s federal response. Instead of being allowed to recover, Puerto Rico is being threatened with cuts, with one million residents at risk of losing their already-insufficient Medicaid coverage in September. I applaud Senator Sanders and his colleagues for introducing the Territories Health Equity Act of 2019 to ensure that Puerto Rico’s vulnerable families receive full, open-ended federal funding for need-based care. This is a vital step in Congress’s recognition that Puerto Rico can no longer be treated as a colony, and moreover, a step toward social justice,” said Carmen Yulín Cruz, Mayor of San Juan, Puerto Rico.

 

“The U.S. government can no longer turn its back on the American citizens of Puerto Rico, and treat us as second class citizens. That is why we support Senator Sanders’ Territories Health Equity Act of 2019 which will finally result in a permanent fix to the discriminatory and unequal Medicaid and Medicare funding for Puerto Rico, the USVI and all territories. This is more urgent than ever since Puerto Rico faces an upcoming ‘Medicaid cliff’ which, if not funded by the end of 2019, may result in 600,000 Puerto Ricans become uninsured overnight,” said Dr. Jaime R. Torres of Latinos for Healthcare Equity.

 

“U.S. territories have had to withstand decades of unequal and colonialist treatment. In the last couple of years, they have also had to withstand the increasing impacts of climate change with direct hits from record-setting tropical cyclones. This time, the already suffering and vulnerable people in these U.S. territories face another catastrophic threat, this time to their medical care, which can be easily adverted by the U.S. Congress, if its members decide to put the well-being of its colonial subjects at the same level as those U.S. citizens living in the states," said Edil Sepúlveda, Co-founder of Boricuas Unidos en la Diáspora.

 

Senator Warren has been a steadfast champion for Puerto Rico. For more information about her extensive work fighting for robust recovery efforts for Puerto Rico and the U.S. Virgin Islands since Hurricanes Irma and Maria, visit www.warren.senate.gov/puertorico.

 

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