Territories Health Equity Act of 2023
If enacted, HB 1029 would have a substantial impact on healthcare funding in the territories. The bill seeks to eliminate general Medicaid funding limitations starting in fiscal year 2024, which would allow territories to receive a more equitable share of federal funding. Particularly, for Puerto Rico and similar entities, it removes existing caps on Medicaid funding and proposes higher reimbursement rates. The elimination of late enrollment penalties under Medicare Part B for Puerto Rican residents represents another critical change that aims to increase access to Medicare benefits for individuals who might have faced barriers previously.
House Bill 1029, known as the Territories Health Equity Act of 2023, aims to amend titles XVIII and XIX of the Social Security Act to improve the treatment of United States territories, including Puerto Rico, under Medicare and Medicaid programs. This bill introduces significant changes designed to eliminate existing funding limitations, secure additional medical assistance, and enhance inequities faced by these territories compared to states. Its provisions cover Medicaid funding limits, eliminate specific Federal Medical Assistance Percentage (FMAP) limitations, and permit Medicaid Disproportionate Share Hospital (DSH) allotments for territories.
However, the bill is not without controversy. Supporters argue that it addresses long-standing inequalities in healthcare funding for U.S. territories, providing needed resources for hospitals that serve vulnerable populations. Conversely, critics express concerns that the provisions may lead to increased federal spending without adequate controls and that funding enhancements could encourage dependency on federal assistance. The debate around HB 1029 reflects broader issues concerning funding disparities and health equity within the American healthcare system, particularly for territories that have historically been treated differently than states in the allocation of healthcare resources.