Puerto Rico Goes to Washington
Dr. Juan Panelli of Amor Que Sana presses for expanded health care access for Puerto Rico
Puerto Rican AIDS advocates met with Congress and the White House last week to ensure that (contrary to the status quo) the territory isn’t left out of healthcare reform. They spoke out about about disparities in housing, access to drug treatment, the Ryan White Care Act— and the federal Medicaid cap that dramatically limits health care on the island.
The delegation, which included representatives from CAIM, Amor Que Sana and Housing Works, as well as independent Puerto Rican activists, scored small but important victories. After meeting with the advocates, the White House announced that Puerto Rico will be a location for one of its fall town hall meetings to gather community perspective on the National HIV/AIDS Strategy. (Other locations will be Washington, D.C., New York City, San Francisco, Oakland, Los Angeles, Houston, Albuquerque, Mississippi, Ft. Lauderdale, Minneapolis, Columbia, South Carolina and the Virgin Islands.)
And a meeting with Health and Human Services (HHS) ended with Christopher Bates, director of HHS’ Office of HIV/AIDS Policy, promising to produce a needs assessment on how money is being provided and how it’s being delivered in Puerto Rico.
The group’s meeting with Housing and Urban Development (HUD) was also productive. All of the approximately $20 million in U.S. AIDS housing funding goes through the Puerto Rican government, but government mismanagement has made reimbursement difficult for housing providers. The Puerto Rican delegation is providing a list of grievances that HUD promised it will address.
“It was important to be able to explain to our policymakers how desperate and complicated the issue of drug treatment and HIV and homelessness is in Puerto Rico,” said Rafael Torruella, an expert on the Puerto Rico AIDS crisis who participated in the lobby visits.
The delegation also met with Rep. Donna Christen-Christiansen; representatives from Puerto Rico’s Resident Commissioner Pedro Pierluisi’s office; and representatives from the offices of Sen. Max Baucus and Reps. Nydia Velazquez and José Serrano.
The Commonwealth of Puerto Rico contributes approximately $1.7 billion per year toward Medicaid. The U.S. government caps its Medicaid spending in Puerto Rico at approximately $250 million per year, eight percent of the total cost of the program. No such cap applies in the 50 states, where the minimum amount the U.S. government pays is 50 percent. In 2008, the U.S. spent approximately $20 per Medicaid participant per month in Puerto Rico, compared to $330 per participant per month in the U.S.
Where is Pierluisi?
The advocates were disappointed by their meeting with Pierluisi’s office, whom they originally assumed would share their outrage at the lack of health care in Puerto Rico. But they were told that Pierluisi wasn’t committed to lifting the cap on Medicaid funding. He is, however, calling for a bill attached to health care reform that would triple the cap and also signed on to a letter to Speaker Nancy Pelosi calling on Congress to treat Puerto Rico and other territories like a state in health care reform.
“I feel I don’t have a real representative who can serve as a spokesperson. Mr. Pierlusi is supposed to be there, but he doesn’t know anything about our concerns,” said Francisco Rodriguez, director of Amor Que Sana, an AIDS service organization in Ponce, Puerto Rico.
Posted on July 31, 2009 at 12:12 am
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