Omnibus bill includes some important Medicaid provisions for Puerto Rico & other U.S. Territories

Yesterday I noted that the big year-end federal omnibus spending bill includes provisions which allow states to start kicking people off of Medicaid who are only eligible thanks to the COVID-19 public health emergency bills passed in 2020 & 2021..but it at least does so in a fairly responsible way by phasing out the extra federal matching funds gradually over a 9-month period, to prevent states from dumping everyone all at once.

The omnibus bill also includes other important positive Medicaid provisions such as letting children who are eligible for the program stay on it for at least 12 months regardless of  household income changes, and letting states offer 12 months of postpartum Medicaid/CHIP coverage to newborn children & their mothers on a permanent basis instead of the current 5-year limit.

Over at the Georgetown University Health Policy Institute, Edwin Park has put together a summary of additional Medicaid enhancements specifically targeting the U.S. Territories: Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands and the Northern Mariana Islands.

As Park notes:

Unlike for the states, federal Medicaid funding for Puerto Rico and the other territories is capped, with the regular block grant amounts set at highly inadequate levels.  Moreover, the regular federal Medicaid matching rate (known as the FMAP) for the territories is set at 55%, even though the FMAPs for the territories would equal 83% if they were calculated in the same way the matching rate for states is determined, due to the territories’ lower per-capita income. 

...Under the latest funding extensions, Puerto Rico’s FMAP was set at 76% and the FMAPs for American Samoa, Guam, the Northern Mariana Islands and the U.S. Virgin Islands was set at 83%.  But after December 23, 2022, the FMAPs for all the territories will revert to the regular 55%.

...The omnibus bill would extend the 76% FMAP for Puerto Rico for another five years (through the end of federal fiscal year 2027) and extend the 83% FMAPs for the other territories on a permanent basis.  ...This would ensure greatly needed fiscal stability for Puerto Rico for the medium term and for the other territories over the long term and thereby increase access to needed care for low-income individuals and families in Puerto Rico and the other territories.