Speaker Ryan must step up for Puerto Rico
© Greg Nash

Saying the Commonwealth of Puerto Rico is facing tough economic times is putting it mildly. The Island has an unemployment rate of 12.4 percent, and a 45 percent poverty rate. Puerto Rico also owes creditors more than $70 billion dollars. In the next fiscal year, its economy is expected to shrink by 16.2 percent. Making matters worse, the island is facing a serious brain drain, with many of Puerto Rico’s best and brightest leaving their homes in order to find better economic opportunities on the U.S. mainland. Puerto Rico’s problems don’t end there, either…

As you read this, a drama is unfolding in Washington and Puerto Rico simultaneously. On the Caribbean island, there is a grave sense on foreboding, due to the fact by the end of the year the commonwealth could essentially run out of Medicaid funding. In Washington, Speaker of the House Paul RyanPaul Davis RyanOn The Trail: Retirements offer window into House Democratic mood Stopping the next insurrection Former Sen. Bob Dole dies at 98 MORE (R-Wis.) is contemplating whether or not to step in to help fix this situation by appropriating adequate funding to prevent the Medicaid from going broke in Puerto Rico.


Let me be clear: Congress needs to ensure that Medicaid is properly funded in Puerto Rico and this cannot be up for a serious debate.

Puerto Rico is an American territory and a vast majority of residents there are American citizens. We cannot allow seniors living in Puerto Rico to go without medical care. This is simply not acceptable in the United States. I am not the only one to feel this way. In fact, over 70 Members of Congress (all Democrats) recently wrote to Ryan, urging him to address this awful situation.

At the heart of the problem, is that Puerto Rico’s Medicaid program receives a lower reimbursement rate than do the mainland states. Currently, the federal government supplements that low rate to safeguard Medicaid in Puerto Rico; ensuring the federal program has enough funding so that patients can afford to see doctors and secure adequate medical treatment. However, the federal grant which provides this supplemental Medicaid funding to Puerto Rico is going to expire soon, meaning funds could run dry before the end of 2017.

According to the letter sent by those members of Congress to Ryan, if the Congress does not step in to continue this supplemental funding, it could result in nearly one million residents of Puerto Rico to be denied healthcare coverage.

Another concern is that if Congress should fail to appropriately address this matter before the end of the year, thousands of Puerto Ricans may come to the mainland United States for medical treatment – which as American citizens they have the right to do. Making this situation even worse, is that medical treatment costs more on the mainland that it does in Puerto Rico. Ultimately, this means that the American taxpayer will have to pay more – not less – to provide our fellow countrymen and countrywomen with appropriate healthcare.

Thankfully, the Puerto Rico Oversight, Management, and Economic Stability Act (PROMESA) – created last year between Ryan and President Barack ObamaBarack Hussein ObamaDemocrats make final plea for voting rights ahead of filibuster showdown Biden nominates Jane Hartley as ambassador to UK To boost economy and midterm outlook, Democrats must pass clean energy bill MORE – developed bipartisan and fiscally responsible legislation to deal with the Puerto Rico’s looming Medicaid cliff. In the letter to Ryan, the members wrote: “Enacting such legislation immediately is essential to provide Puerto Rico’s Medicaid agency with the certainty it needs to engage with the managed care organizations that operate the island’s Medicaid program.”

Certainly, Congress is right to blame both the Island’s leadership and the creditors, whose combined efforts have created this terrible scenario. However, a vast majority of the seniors that could be left without healthcare bear no responsibility for the debt crisis. More importantly, they pay taxes and for a hundred years, Puerto Rican men and women have fought and died serving in our armed forces. We are the wealthiest nation on the planet and we cannot just turn our backs on our fellow citizens. This is a life and death matter and Ryan must do the right thing and ensure that Medicaid in Puerto Rico does not go broke. 

Reyes represented Texas’ 16th District in Congress from 1997 - 2013.

The views expressed by this author are their own and are not the views of The Hill.