Lawmakers leave for Washington to lobby for Medicaid parity.

Speaker of the Puerto Rico House of Representatives Carlos “Johnny” Méndez Nuñez

By THE STAR STAFF

Island lawmakers are traveling to Washington, D.C., this week to lobby members of Congress and officials in the executive branch to preserve the island’s current Medicaid funding levels, which are scheduled to expire on Sept. 30, 2027.

Speaker of the Puerto Rico House of Representatives Carlos “Johnny” Méndez Nuñez said Sunday that the delegation will focus on maintaining the 76% federal reimbursement rate that has been in place since 2021 under a five‑year agreement.

Medicaid finances the Vital Plan, Puerto Rico’s public health insurance program for low‑income residents. More than 1.5 million people depend on the system, which costs over $2.3 billion a year. Under federal law, Puerto Rico normally receives a capped federal match of 55% -- far below the open‑ended formula used for U.S. states -- leaving the island responsible for the remaining share. Congress has repeatedly approved temporary increases, beginning with a two‑year boost after Hurricane Maria and continuing through subsequent extensions, including the current 76% rate.

Méndez said the delegation will meet with lawmakers and administration officials to underscore the importance of stable funding for the roughly 700,000 Puerto Ricans whose health coverage depends on Medicaid. He added that the group will also advocate for implementing recommendations from the Bipartisan Congressional Task Force on Economic Growth in Puerto Rico, which concluded in 2016 that equal Medicaid funding is essential to the island’s long‑term economic development. The trip is being coordinated with the Puerto Rico Federal Affairs Administration.

While House Resolution 1, or the One Big Beautiful Bill Act, introduced a $1 trillion reduction to the national Medicaid program over the next decade, it did not include immediate cuts to Puerto Rico’s base Medicaid funding.

The visit comes as the Trump administration has tied any long‑term extension to stronger oversight and program integrity measures. Administration officials have emphasized the need for “fiscal sustainability” in federal health programs and have argued that any additional Medicaid support for Puerto Rico should be temporary and conditioned on reforms. They have also called for structural improvements to the island’s health system, including better data reporting, stronger anti‑fraud controls, and modernization of Medicaid administration.

While some members of Congress support granting Puerto Rico full parity with the states, the administration has not endorsed that approach, instead favoring time‑limited funding packages with accountability requirements. Officials have acknowledged Puerto Rico’s fiscal constraints under the Puerto Rico Oversight, Management and Economic Stability Act, or PROMESA, but have framed them as a reason for responsible budgeting rather than a justification for permanent increases.

Méndez said the delegation intends to present the case that maintaining the current reimbursement rate is essential for the island’s health system and economic stability, and that the federal government should avoid creating another Medicaid funding cliff in 2027.