The Insufficiency Of Medicaid Block Grants: The Example Of Puerto Rico

Medicaid block grants have been a centerpiece of Republican health proposals for more than a decade. Proponents, including House Speaker Paul Ryan (R-WI), argue that giving states a fixed amount of money through a block grant or per-person limit with few strings attached gets Washington out of the way and allows for state innovation. Although the most recent block grant legislation did not reach the Senate floor, proponents have promised to continue to push for it. But one need look no further than the growing health crisis in Puerto Rico to understand why capped federal money and state flexibility will not solve serious health care issues. Puerto Rico Has Been A Laboratory For Block Grants Unlike states, Puerto Rico’s federal Medicaid funding is provided through a lump sum of federal funds: a block grant. Over the years, this approach has proven insufficient to address the island’s significant health needs. Even before Hurricanes Maria and Irma, Puerto Rico faced significantly higher rates of chronic diseases such as coronary heart disease and asthma, as well as higher rates of premature births and infant mortality, compared to rates in the mainland United States. The supply of available providers, particularly for specialist services, is below average. Access to treatment that meets the standards of care generally lags national averages. And to get care, Puerto Rico residents must wait significantly longer and travel further than their peers in the mainland United State...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Medicaid and CHIP block grants disaster relief Puerto Rico Source Type: blogs