How underfunding Puerto Rico’s health system costs governments more money than it saves

A fiscal crisis looms on the island of Puerto Rico, and the controversy – about health care spending – has far-reaching implications that extend well beyond the Atlantic coastlines of the United States’ largest territory. At stake are the long-term health of the Puerto Rican population, the pragmatic use of the U.S. taxpayers money and the flow of Puerto Rican citizens from their island to mainland states.As soon as December 2017, the territory faces a terrifying deadline. That month brings Puerto Rico face to face with the Medicaid Funding Cliff, when money allotted under the Affordable Care Act (ACA) to finance the Medicaid is projected to run out. That will reduce the annual Puerto Rico Medicaid Budget by $1.2 billion, risking the coverage of more than 817,000 Medicaid and nearly 300,000 dually eligible patients (PR Medicaid, 2017).

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