A NYSNA delegation attended the fall “SOMOS el Futuro” conference in Puerto Rico November 4 - 8, where they saw up close the effects of Puerto Rico’s current economic and healthcare crises. Michelle Gonzalez, RN, Montefiore Medical Center, was one of three NYSNA nurses who participated. “This was my first SOMOS conference,” she said, adding, “My family is Puerto Rican so I was glad to come and learn more about what is happening here.” Fellow Montefiore RN Karines Reyes-Urbez and Kirsys Baez, RN at Elmhurst Hospital, also were there.
The island’s debt crisis is tied to healthcare underfunding from the federal government and a further cut of $500 million is scheduled. That’s left Puerto Rico reeling. Nearly 30% of Puerto Rico’s $70 billion debt is a direct result of having to borrow to pay for Medicaid.
Root of Problem
Living on a U.S. territory, Puerto Ricans pay the same Medicare and Social Security payroll taxes as those who live on the mainland, but there’s a huge difference in what they get back. Congress has long capped the federal Medicare and Medicaid reimbursement that PR receives at levels far below that of any of the 50 states. For years, it has paid just 15% of the island’s Medicaid costs; in contrast, it contributes 50% in New York State and up to 80% in poorer states like Alabama and Mississippi. With a poorer and older population than any state, Medicare and Medicaid provide health coverage for 70% of the island’s 3.5 million people. Further cuts have the potential to cause the Puerto Rican healthcare system to collapse.
The problem is compounded by the fact that Puerto Rico does not have access to the same types of bankruptcy protections that federal law grants to states. “I didn’t realize how bad it was until I saw it in person,“ said Michelle Gonzalez. “Puerto Ricans are U.S. citizens but aren’t treated as such.”
The highlight for the NYSNA members was the November 5 United for Health rally to demand parity from Congress in Medicare and Medicaid funding. The three nurses marched alongside an estimated 50,000 people from labor, community, healthcare, religious, and political groups that comprise the Puerto Rico Healthcare Crisis Coalition. President Obama, Governor Cuomo and many in New York’s political leadership are making efforts to help, but, under current law, only Congress has the power to make things right.