What the AHCA could mean for Puerto Rico and the other territories
House Bill 1628, also known as the American Health Care Bill (AHCA), passed the House on May 4, on a close vote of 217 to 213. It will have many effects if it is turned into law, including removing power from the pre-existing condition mandate of the Affordable Care Act (ACA), as well as ending the individual mandate. These mandates require that an insurance company cannot deny someone insurance because they have a health condition, and require that every person have health insurance. The weakening of them allows for insurers to charge extremely high prices to “high risk” customers, and allows for an extremely under-funded system. The bill will also cut the additional federal funding to Medicaid that was made available after the ACA went into effect. It is estimated that 19.7 million Americans will lose their healthcare by 2026.
While the ACA had only two pages dedicated to how it would affect the different US territories, the new healthcare bill includes even less information, mentioning Puerto Rico and the other territories of the US Virgin Islands, Guam, American Samoa and the Northern Mariana Islands a grand total of zero times. Because Puerto Rico and the other territories are treated differently when it comes to funding for healthcare, it is difficult to know how the AHCA will truly affect them. It is certainly possible that some may lose coverage, from federal or private insurance agencies, as Medicaid funding is cut, and consumer protections are weakened.
There are other bills and issues that affect Puerto Rican healthcare. The Consolidated Appropriations Act, formerly House Bill 244, was passed into law on May 5, and includes almost $300 million in funding for Puerto Rican Medicaid, aiming to address the territory’s Medicaid cliff. This may help alleviate the effects of the AHCA’s medicaid funding cut.
Healthcare is often an uncertain situation for many Americans, and no where does that appear to be more true currently than in the US territories. The healthcare debate is polarizing and lengthy. There is still significant time for alterations, as it must pass through the Senate and onto the President before it goes into action, allowing for addition of talk of the territories, and only time will tell what healthcare changes will occur, if any.
