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senate Bill S. 1961

Expanding Medicare and Medicaid into U.S. Territories

Argument in favor

U.S. territories like Puerto Rico rely on Medicare and Medicaid to give their elderly and poor access to health care. Those U.S. shouldn’t be disadvantaged under such critical programs, and deserve to be treated like states for those purposes.

AndrewGVN's Opinion
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12/01/2015
It's amazing to me how many Republicans are for increasing the HUGE military budget, but think that this will cost to much, and we shouldn't expand services to help middle-low income families. They deserve the services of social programs that are used in the United States. Extending Medicare and Medicaid over to small territories such as Puerto Rico and Guam, will not cause a huge increase in expenses for the social program. Sadly, the way our healthcare is in the United States, thousands die yearly due to not being able to afford healthcare, and we should look at this, and provide as much healthcare to the people that cannot afford the insanely high health insurance rates, compared to Canada and European nations that provide low rates for healthcare, and provide healthcare as a human right.
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Mikeizzo1993's Opinion
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11/29/2015
Expanding healthcare to those in need is a fraction cost compared to what we waste on defense and corporate welfare.
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Leo's Opinion
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11/24/2015
They are American citizens with all rights, duties and privileges that entails.
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Argument opposed

A territory is not a state, and should be treated as such when federal funding from programs like Medicare and Medicaid is disbursed. Puerto Rico could choose to become a state on its own, which would solve the problem from its standpoint.

BTSundra's Opinion
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11/21/2015
They don't contribute to the program, and therefore should not be eligible for it whatsoever.
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LibertyForAll's Opinion
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12/30/2015
Between the existing entitlement programs, military spending and fledgling status of the US dollar as the World Reserve Currency. America can literally not afford to subsidize such a gamble.
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operaman's Opinion
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11/21/2015
Not a good idea. All our territories will stampede for services. More costs for taxpayers who supported Medicaid and Medicare from it's conception. These programs are doomed for insolvency in our near future anyway, so no. Besides, most of our territory are poor and couldn't support the current system.
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What is Senate Bill S. 1961?

This bill would eliminate disparities in Medicare and Medicaid coverage that disadvantage U.S. territories (like Puerto Rico, American Samoa, and Guam) when funds are disbursed to territorial governments and health care providers.

The cap on Medicaid funding for territories, and the limitation on the percentage of medical assistance the federal government can provide through Medicaid would be eliminated. All territories would be granted waiver authority for Medicaid, and the 100 percent of the federal poverty line limitation would be applied to all territories.

Territories would be included in the Medicaid disproportionate share hospital (DSH) program which provides additional funding to hospitals that treat a high percentage of low-income and uninsured patients. The formula used to compute DSH funding would also be changed for Puerto Rico to exclude the number patients enrolled in the federal Supplemental Security Income program which doesn’t cover the territory.

Base Medicare payment rates to hospitals in Puerto Rico would be adjusted upwards to ensure uniformity in base rates, as states all receive the same base rate. Puerto Rican hospitals would no longer be excluded from Medicare’s HITECH program, which allows hospitals that adopt electronic health records to receive bonus payments.

Physician compensation rates under Medicare would be subject to a new formula for calculating the geographic practice cost index (GCPI). A floor on Medicare payments under the GCPI would be established to help fairly compensate physicians in Puerto Rico.

Puerto Rico’s Medicare Advantage (MA) beneficiaries would receive additional compensation, as the territory’s MA plans would be covered by a payment floor.

Impact

Medicare and Medicaid beneficiaries in U.S. territories, physicians and health care providers serving those beneficiaries, governments of U.S. territories, and the Centers for Medicare and Medicaid Services.

Cost of Senate Bill S. 1961

A CBO cost estimate is unavailable.

More Information

In-Depth: Sponsoring Sen. Chuck Schumer (D-NY) introduced this legislation to ensure fairness for U.S. territories with respect to Medicare and Medicaid funding, particularly Puerto Rico:

“Residents of Puerto Rico are American citizens and deserve access to quality health care so it is essential that we provide it with the resources to fairly fund its Medicaid and Medicare programs. The bottom-line is: Puerto Rico should be offered the same treatment under federal health programs as states, and that’s why Congress should pass this critical piece of legislation.”

Currently this bill has five Democratic cosponsors in the Senate, while its House companion has another five Democratic and one Republican cosponsors. The bill has yet to receive a vote in either chamber.


Media:

Summary by Eric Revell
(Photo Credit: Flickr user Pacific Air Forces)

AKA

Improving the Treatment of the U.S. Territories Under Federal Health Programs Act of 2015

Official Title

A bill to amend titles XVIII and XIX of the Social Security Act to make improvements to the treatment of the United States territories under the Medicare and Medicaid programs, and for other purposes.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The house has not voted
  • The senate has not voted
      senate Committees
      Committee on Finance
    IntroducedAugust 5th, 2015
    It's amazing to me how many Republicans are for increasing the HUGE military budget, but think that this will cost to much, and we shouldn't expand services to help middle-low income families. They deserve the services of social programs that are used in the United States. Extending Medicare and Medicaid over to small territories such as Puerto Rico and Guam, will not cause a huge increase in expenses for the social program. Sadly, the way our healthcare is in the United States, thousands die yearly due to not being able to afford healthcare, and we should look at this, and provide as much healthcare to the people that cannot afford the insanely high health insurance rates, compared to Canada and European nations that provide low rates for healthcare, and provide healthcare as a human right.
    Like (12)
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    They don't contribute to the program, and therefore should not be eligible for it whatsoever.
    Like (11)
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    Expanding healthcare to those in need is a fraction cost compared to what we waste on defense and corporate welfare.
    Like (11)
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    Share
    Between the existing entitlement programs, military spending and fledgling status of the US dollar as the World Reserve Currency. America can literally not afford to subsidize such a gamble.
    Like (9)
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    They are American citizens with all rights, duties and privileges that entails.
    Like (7)
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    If they're US citizens they should get all the services.
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    People in Puerto Rico and Guam should not be treated as second class.
    Like (6)
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    They have the right to affordable healthcare
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    If they have American citizenship they are grated the rights and liberties (and therefore benefits). American territories hold primaries for President. What makes them so different from the citizens who live on the mainland (and Hawaii). An American is an American. They deserve all the benefits any other American possesses.
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    Not a good idea. All our territories will stampede for services. More costs for taxpayers who supported Medicaid and Medicare from it's conception. These programs are doomed for insolvency in our near future anyway, so no. Besides, most of our territory are poor and couldn't support the current system.
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    If Puerto Rico or other territories want to be treated like a state, then they should vote to become one. If they choose not to become a state then they are not entitled to funding that goes to states.
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    Territories should have rights
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    PR pays taxes for Medicare and Medicaid in full and so they should receive benefits in full.
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    Puerto Ricans already pay the same federal Medicare taxes as other Americans, so giving them the same Medicare benefits is only fair.
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    Just on the simplest facts of paying the same taxes gives them these rights.
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    They're Americans Too
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    Puerto Rico has had ample opportunity to push for statehood over the last several decades, and majorities have consistently polled for the status quo over statehood or independence - they presumably like their special benefits that states do not get. Well, there are downsides too. They should live with it, and start lobbying for a final change in status if they don't like it.
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    Territories don't contribute to the US treasury and therefore should not benefit from our hard earned funds
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    A territory is not a state, and should be treated as such when federal funding from programs like Medicare and Medicaid is disbursed. Puerto Rico could choose to become a state on its own, which would solve the problem from its standpoint.
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    If they contribute to these services and become States then they can get those benefits.
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