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  • Health Centers in Puerto Rico: Operational Status after Hurricane Maria

    Fact Sheet

    In the aftermath of Hurricane Maria, Puerto Rico's health centers, a critical part of the island's health care system are working to rebuild; however, recovery remains slow and plagued by many challenges. This interactive map provides a snapshot of the operational status of the 93 health center sites in Puerto Rico.

  • Voices from Puerto Rico: Reflections Two Months After Maria (Report)

    Issue Brief

    Two months after Maria made landfall, Kaiser Family Foundation staff traveled to Puerto Rico. This brief presents findings from focus groups and individual interviews with 40 individuals from 10 different regions on the island affected by the storm.

  • Voces de Puerto Rico: Reflexiones Dos Meses Después de María (Video)

    Video

    En este video, los residentes de Puerto Rico hablan sobre su vida cotidiana y puntos de vista de los esfuerzos de recuperación dos meses después del huracán María. Describen un clima de frustración, la pérdida de empleo y problemas económicas, la falta de servicios básicos como la electricidad y el efecto en la salud mental y física de la población

  • Health Care in Puerto Rico and the U.S. Virgin Islands: A Six-Month Check-Up After the Storms (Report)

    Issue Brief

    Puerto Rico and the U.S. Virgin Islands suffered significant damage to their infrastructure and health care systems from Hurricanes Irma and Maria in September 2017. Drawing on interviews with residents and key stakeholders as well as public reports, this brief provides an overview of the status of the recovery efforts six months after the storms, with a focus on the health care systems.

  • Challenges in the U.S. Territories: COVID-19 and the Medicaid Financing Cliff

    Issue Brief

    More than a year into the public health emergency, the COVID-19 pandemic continues to impact the lives of Americans including those living in the U.S. territories. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health systems challenges for the territories. While additional federal funds have been provided over the statutory caps, these funds are set to expire at the end of September 2021. Without additional Congressional action, the territories will lose the vast majority of Medicaid financing which could result in reductions in coverage, services, and provider rates which could negatively impact the territories as they deal with the long-term health and economic consequences of the pandemic. This brief looks at how the pandemic is affecting the territories as well as issues related to the upcoming Medicaid fiscal cliff.

  • Community Health Centers in the U.S. Territories and the Freely Associated States

    Issue Brief

    The U.S territories and the Freely Associated States (FAS) have faced an array of longstanding fiscal and health challenges, made worse by recent natural disasters and the coronavirus pandemic. Community health centers are an important part of health care system in the territories and FAS, providing access to a range of primary care services to low-income and vulnerable individuals. Based on findings from a survey of health centers, data from the Uniform Data System (UDS), and interviews with Primary Care Associations in those regions, this brief examines the roles of health centers in U.S. territories and FAS during the COVID-19 pandemic.

  • Medicaid: What to Watch in 2019 from the Administration, Congress, and the States

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Important Medicaid issues to watch in 2019 include Medicaid expansion developments amid ongoing litigation about the ACA’s constitutionality as well as Medicaid demonstration waiver activities, including those focused on work requirements and other eligibility restrictions. States are also likely to continue to pursue initiatives to address the opioid crisis, and the recent passage of bi-partisan legislation with new tools and financing could bolster these efforts. Primary areas of federal policy to watch in 2019 with implications for Medicaid include the expiration of temporary funding for Puerto Rico and the US Virgin Islands in the absence of legislative action as well as potential regulatory changes to public charge policies that would likely lead to Medicaid enrollment declines among immigrant families. Finally, reforms in benefits, payment and delivery systems continue to evolve as states and the federal government focus on managed care, social determinants of health, prescription drugs, and community based long-term care. While beyond the scope of this brief, Congress and states could also consider broader health reform that could expand the role of public programs in health care including Medicare for All or Medicaid buy-in programs that could have significant implications for Medicaid.

  • Medicaid Financing Cliff: Implications for the Health Care Systems in Puerto Rico and USVI

    Issue Brief

    This brief provides an overview of the status of the health care systems and Medicaid programs in Puerto Rico and the U.S. Virgin Islands (USVI) about one and a half years after Hurricanes Irma and Maria struck the islands in September 2017. The hurricanes exacerbated the territories’ existing economic and health care challenges by accelerating outmigration of residents and health care providers and destroying homes, schools, health care facilities, and other infrastructure. After the storms, the territories’ Medicaid programs have served as important resources for addressing residents’ health care needs, but they have operated under longstanding financing challenges. This brief focuses on these challenges and includes KFF analysis of the implications for the territories’ Medicaid program finances, as most of the temporary federal Medicaid funds provided through the Affordable Care Act (ACA) and disaster relief are set to expire at the end of September 2019. The other U.S. territories (American Samoa, the Commonwealth of the Northern Mariana Islands, and Guam) also face challenges tied to the scheduled expiration of ACA funds.