Health Equity for US Territories: Ending Medicaid Caps and Improving Medicare Access.
This law significantly boosts federal health funding for U.S. Territories (including Puerto Rico and Guam) by eliminating the cap on Medicaid funding, ensuring more stable and comprehensive medical services for residents. It also introduces crucial changes to Medicare, including automatic prescription drug subsidies for low-income seniors and access to health coverage similar to that available to Congress members in areas lacking local insurance exchanges.
Key points
End of Medicaid Funding Caps: Territories will receive uncapped federal Medicaid funding, similar to states, drastically improving healthcare stability and access starting in fiscal year 2026.
Better Medicare for Seniors: Low-income residents will automatically qualify for help with prescription drug premiums and costs (Part D subsidies), and late enrollment penalties for Part B will be eliminated for certain residents in Puerto Rico.
Increased Hospital Support: Changes to hospital funding rules (DSH and base payment rates) aim to increase resources for facilities serving a high number of low-income patients.
Access to Health Insurance: Residents of territories without local ACA Exchanges will gain access to health plans similar to those offered to Congress members, including eligibility for federal tax credits.
Introduced
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