Governor Cuomo and Delegation Representatives Urge Federal Government to Make Health Funding Formulas Equitable to Puerto Rico
New York State to Help Puerto Rico’s Government Streamline Health Care System and Apply for Federal Redesign Funds
Delegation Announces Initiatives to Aid Puerto Rico in Energy and Infrastructure; Agriculture; Tourism; and Business and Tech Development
Governor Cuomo announced an aggressive action plan to assist the government of Puerto Rico during a time of crisis related to its health care system and economy. The Governor and members of a solidarity delegation, which includes more than a dozen elected and industry representatives from New York, discussed the plan at the University of Puerto Rico’s Medical Sciences Campus in San Juan in front of an audience of roughly 400 medical students and local residents. The plan was announced during the final hours the delegation’s trip to Puerto Rico at the invitation of Puerto Rico’s Governor, Alejandro García Padilla.
“This trip is about fighting to achieve fairness and parity for Puerto Rico,” said Governor Cuomo. “The federal government needs to step up for Puerto Rico, and I am proud to have joined Governor Garcia Padilla to highlight the problem and help his administration find a path back to prosperity. New York and Puerto Rico have always shared a strong bond, and together we can make a difference in the lives of millions of people.”
“The fiscal sustainability of Puerto Rico depends in no small part on Washington providing equitable healthcare treatment. I thank Governor Cuomo and other New York officials for standing with the people of Puerto Rico in demanding that the American citizens of Puerto Rico be treated fairly,” said Governor Alejandro García Padilla. “We look forward to collaborating with our colleagues in New York as we seek to gain equitable treatment from the federal government and modernize our healthcare system."
HEALTH CARE ISSUES
Puerto Rico’s current health care crisis
Nearly 68 percent of the residents of Puerto Rico receive their health care through Medicare, Medicare Advantage or Medicaid. Unfortunately for the Puerto Rican government, federal funding formulas for these three programs are dramatically less favorable to Puerto Rico than they are for the 50 states.
Because the basic Medicare program is less favorable to residents of Puerto Rico than in the 50 states, approximately75 percent of all Medicare beneficiaries in Puerto Rico are in the Medicare Advantage program. Federal support for the Medicare Advantage program in Puerto Rico is 40 percent lower than in the next lowest region in the United States. Puerto Rico's health funding crisis is compounded by the fact that Medicare Advantage rates are scheduled to decline even further in 2016.
Puerto Rico’s federal matching funds for Medicaid are capped at approximately $400 million annually. Puerto Rico has been relying on a block grant of $6.4 billion that it received in 2001 to support its Medicaid funding, but it is expected that these funds will be fully expended by 2017.
Finally, although health care insurers in Puerto Rico spend approximately $185 million annually on Affordable Care Act related taxes, residents of Puerto Rico are not eligible for subsidies on the federal health insurance exchange, making commercial health insurance coverage unaffordable for many Puerto Ricans.
Federal government urged to address funding formula inequities
Governor Cuomo and delegation representatives will press the federal government to provide parity in federal funding for healthcare for Puerto Rico and replenish the block grant on which Puerto Rico relies. Providing an adequate level of funding will enable the government to focus more directly on transforming health care delivery system to reduce costs and improve outcomes, as well as strengthen the local economy, since healthcare represents approximately 20 percent of the Puerto Rican economy.
Governor Cuomo’s administration to help Puerto Rico develop a transformation plan for its health care system
Since 2011, Governor Cuomo's Medicaid Redesign Team has significantly improved the efficiency of New York State's health care delivery system – both in terms of reducing costs and improving patient outcomes. This transformation was recognized and supported by the federal government in 2014, with an $8 billion funding commitment in the form of a “Medicaid Waiver.”
Representatives from the New York State Department of Health will provide technical assistance to Puerto Rico in developing a transformation plan as part of an application to the federal government for a similar investment to implement the type of health system redesign strategies that had been successful in New York State. This team will include key staff members who were involved in New York’s successful Medicaid Waiver negotiations with the federal government. The transformation plan will focus on the elements of program design, performance measurement, and shared savings that have proven effective in New York. Governor Cuomo’s administration will also share its experience in developing a state-of-the-art Medicaid Management Information System and the use of data mining solutions to help identify opportunities to both lower costs and improve outcomes.
Greater New York Hospital Association and 1199 SEIU's successful Healthcare Education Project to partner with the Puerto Rico Hospital Association and healthcare officials in Puerto Rico to help improve outcomes and advocate for parity for federal healthcare funding
In addition to the State Department of Health assisting the government of Puerto Rico, the Greater New York Hospital Association and 1199 SEIIU's healthcare Education Project will form a joint task force with the Puerto Rico Hospital Association and health officials in Puerto Rico to provide technical assistance on financing issues and develop best practices within hospitals that could help address the health care crisis in Puerto Rico, as well as join the effort to secure parity in federal healthcare funding for the Island.
ECONOMY & RELATED ISSUES
In addition to efforts to aid Puerto Rico in its health care crisis, the Governor also announced a number of initiatives designed to help Puerto Rico strengthen and expand its economy.
- Energy and Infrastructure: A team of senior officials from Governor Cuomo’s administration will help the Puerto Rican government decrease dependence on off-island energy sources, as well as transition to renewable power as a way to help the government reduce costs. New York has reduced its own cost of energy to government by aggressively implementing energy efficiency retrofits and deploying more renewable energy, and the Governor’s team will provide advice and guidance based on New York’s experience growing the clean energy economy.
- Agriculture: The Governor’s office will send an agriculture team, including representatives from the New York State Department of Agriculture and Markets as well as Cornell University, to provide Puerto Rico with compliance assistance to meet the federal Food Safety Modernization Act and grow the agricultural sector in Puerto Rico. Additionally, New York will work toward a bilateral trade agreement to help Puerto Rico market products not grown in New York – and in turn, Puerto Rico will purchase New York-grown products not grown on the island.
- Tourism: New York State, through the I LOVE NY campaign, has invested $130 million in tourism over the last 4.5 years. As a result, revenue has surged by $8.5 billion to a record total of $62.5 billion – twice the rate of growth of the other states in the U.S. New York will propose broadening this effort with a $5 million joint I LOVE NY tourism campaign to promote travel between New York and Puerto Rico.
- Business and Technology Development: New York State will hold a Commercialization Summit connecting promising early-stage Puerto Rican businesses, entrepreneurial student and institutions of higher education to New York seed funds in order to foster commercialization and greater economic activity in Puerto Rico.
"The importance of this trip is to show the support from New York with Puerto Rico,” said New York City Council Speaker Melissa Mark-Viverito. “In New York, we have dealt with similar crisis in the past and we can share our experiences and knowledge with the Puerto Rican government. The trip also raises awareness in Washington as we continue to push for an adequate response from the federal government to the health care crisis and the debt crisis on the island. New York and Puerto Rico are inextricably linked, since our state is home to one of the largest Puerto Rican populations in the U.S. I will continue to work with local, state and federal governments to find a resolution to the crisis facing the island. This trip is our way of saying that we will not abandon the Puerto Rican people at this time of need. I thank Governor Cuomo for leading this important trip at a critical time for Puerto Rico."
"Nearly one in ten New York City residents has roots in Puerto Rico, so the crisis is deeply personal for New Yorkers,” said Attorney General Eric Schneiderman. “In the 1970s, New York City went through a similar fiscal crisis; and more recently in New York State, we've achieved a redesign and a successful crackdown on waste and abuse in our Medicaid system. Whether it's fair treatment under the federal Medicaid system, or bankruptcy protections that have been granted regularly to municipalities on the mainland, Puerto Rico officials should have all the tools they need to weather this crisis."
“New York is home to the largest number of Puerto Ricans in the country, and we in the State Assembly stand ready to help in any way possible,” said Assembly Speaker Carl Heastie. “I am proud that New York has taken on this challenge and is leading the way, and the federal government must step up to the plate as well and do all it can to help alleviate this crisis. I thank Governor Cuomo for organizing this critical solidarity mission so that we can listen to the needs of the local officials and its people and determine the best way our state can help Puerto Rico.”
"This trip is of the utmost importance, as the situation Puerto Rico faces will reverberate not only in New York, but across the nation,” said Bronx Borough President Ruben Diaz Jr. “A solution to Puerto Rico's financial woes requires leadership and the ability to build coalitions, and this trip embodies that spirit. I am proud to have joined with Governor Andrew Cuomo and my colleagues in government on this visit to the commonwealth to discuss this issue and possible solutions directly with the government and people of Puerto Rico.”
"This special delegation represents an important opportunity to connect directly with leaders from the worlds of government, business and healthcare, and to bring greater urgency to the search for workable solutions to the current crisis,” said New York City Comptroller Scott M. Stringer. “I look forward to joining Governor Cuomo, Governor Padilla and the entire group as we continue the dialog, and reaffirm the strong bonds between New York and Puerto Rico."
“New York is home to more Puerto Ricans than any other state in the nation – and as New Yorkers it is important for us to make sure Puerto Rico has the help and guidance it needs to resolve its health care and economic challenges,” said Congressman Charles Rangel. “I’m proud to have joined Governor Cuomo on this solidarity mission, and I will stand with him and the rest of our partners – both in New York and in Puerto Rico – in working to address these issues. Together, we can make a real difference in lives of millions of people.”
“It is critical we work together at all levels of government to resolve Puerto Rico’s financial crisis,” said Congresswoman Nydia Velázquez. “I applaud Governor Cuomo for taking a leadership role and adding to the discussion.”
"Helping Puerto Rico resolve its current crisis is both morally and fiscally important for New York City, and I am proud of the work that our delegation is doing alongside our partners in the Puerto Rican government,” said Assemblyman Marcos Crespo. “By working together at the local, state and federal level, we can aid Puerto Rico in its efforts to address the current health care and economic situations and ultimately build a brighter future for the Puerto Rican people."
Governor Cuomo’s Solidarity Mission to Puerto Rico
On Monday, Sept. 8, the delegation departed New York from John F. Kennedy International Airport and arrived in San Juan, Puerto Rico. That evening, Governor and the delegation were greeted by Puerto Rico Governor Alejandro García Padilla at a reception at La Fortaleza. Photos of the delegation’s departure from JFK and the reception at La Fortaleza are available here.
On Tuesday, Sept. 9, Governor Cuomo and members of the delegation met with Puerto Rican officials, including Governor García Padilla to discuss the health care crisis and Puerto Rico’s economic challenges. Following that meeting, the group held a roundtable at the University of Puerto Rico’s Medical Sciences Campus in San Juan to outline the delegation’s action plan to help Puerto Rico address its health care crisis and economic challenges. That roundtable event took place in front of an audience of roughly 400 medical students and local residents.
Video of Governor Cuomo’s remarks at the morning roundtable is available on YouTube here and in TV-quality (h264, mp4) format here, and audio of those remarks is available here. Photos from the roundtable are available here.
Following the roundtable Governor Cuomo and the delegation departed for northern San Juan with Governor García Padilla for a tour of La Placita de Santurce. The group also planned to eat lunch at the locally-owned Restaurant Santaella before returning to New York.