Pandemic Exacerbates Health Care Challenges Facing Puerto Rico and Other U.S. Territories as End of Temporary Federal Medicaid Funding Approach

A recent analysis of KFF examined how coronavirus disease affected U.S. territories as well as issues related to the upcoming termination of temporary Medicaid funding for the territories by the end of September.

Prior to the epidemic, U.S. territories –– American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) — faced a series of with long -standing financial and health challenges exacerbating. through the storms of previous years. These challenges are exacerbated by pandemic disease. As of May 1, every territory, except Puerto Rico and USVI, completely vaccinated more than 30 percent of the eligible population. American Samoa is the only U.S. territory with no cases or deaths to date.

Variations in Medicaid’s financing structure, including a cap that limits federal spending, have contributed to broader financial system and health challenges for the territories. While additional federal funding is provided by statutory caps, these funds are set to expire in September 2021. That will result in the loss of 80 percent of Medicaid funding in the territories and could result in a reduction in coverage, services, and provider rates, even if the territories are facing long-term health and economic consequences of the pandemic.

For a full analysis, as well as other data and studies on the financial and health challenges of the territories, visit

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