Commonwealth Fund January 6, 2021
Edwin Park

Toplines

Puerto Rico’s Medicaid block grant has contributed to the commonwealth’s fiscal and debt crisis

Capping federal funding of Medicaid could shift significant costs to states, as it has done in Puerto Rico

Abstract

  • Issue: Some federal and state policymakers support converting Medicaid into a block grant or “per capita cap” program.
  • Goals: Examine how Puerto Rico’s long-standing experience operating under a Medicaid block grant may predict how states would fare under block grants and per capita caps that limit federal funding.
  • Methods: Review of available data sources, policy analysis, and research related to Puerto Rico’s Medicaid program.
  • Key Findings and Conclusion: Puerto Rico’s block grant funding led to large federal Medicaid funding shortfalls, which contributed to the commonwealth’s...

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