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Welcome to MMAPA

Puerto Rico deserve a health care system that works.

Taking Action

21 professional and health organizations urge HHS to implement 3 concrete and immediate actions to close the disparity gap in federal health funds for Puerto Rico.

 

A group of 21 health-related entities and professional associations joined the Puerto Rico Medicaid and Medicare Advantage Products Association (MMAPA) to urge the Department of Health and Human Services (HHS) to take immediate public policy actions to mitigate the inequity in the budget allocated to the Medicare Advantage program that covers the population of older adults living below poverty levels on the Island.

The group requested 3 concrete measures, one of which can be implemented before the end of 2024.

The first measure that can be done administratively proposes increasing premium payments for MA to the same level paid USVI, which currently in Puerto Rico are 21% below the sister island.

  • The premium payment per person per month received by the MA program in Puerto Rico is currently $672 compared to $847 paid for the MA program in the Virgin Islands.

  • This measure would inject around 1.5 billion additional dollars for Puerto Rico.

  • It will impact approximately 650,000 people over the age of 65, of which 300,000 also depend on Medicaid to receive health services because they live in extreme poverty.

  • Even with this increase, Puerto Rico would be receiving payments well below the $1,102 per person per month assigned to the mainland.

Now is the time to act for the Biden-Harris administration!

Currently, the Centers for Medicaid and Medicare Services (CMS) is drafting the advance notice that will apply for Medicare Advantage in 2025. They have the power to include this adjustment in those new rules.

Closing the disparity gap in the MA program for Puerto Rico was a campaign promise. It's time to act on their word.

Congressional Measures

The other two proposals focus on congressional action:

#1.H.R 4027 Include Puerto Rico in the Medicare Savings Program that covers Part B premiums

  • This is a contribution of $164 per month or $1,968 annually that would go directly into the pockets of MA beneficiaries on the Island.

  • Currently that money is monthly deducted from the Social Security checks of the most vulnerable beneficiaries of Puerto Rico to pay that premium.

  • Puerto Rico is the only US jurisdiction where this premium is not paid to Medicare Advantage patients.

  • Those $1,968 dollars annually would serve to cover many other needs that our older adults have.

#2. H.R.4028 - Inclusion of Medicare Part D Low-Income Subsidy (LIS) program in Puerto Rico which helps pay the drug costs of low-income beneficiaries up to 150% of FPL.

  • This subsidy, that represents $700 million, impacts all dual eligible beneficiaries, and approximately 400,000 citizens who struggle monthly to be able to pay the cost of medications to meet their health needs.

  • Year after year we see how low-income elderly patients stop taking their medications or ration them because at the end of the year, they reached the limit of their medication coverage and do not have the money to pay for them. Then the patient's decompensation begins, increasing visits to emergency rooms and hospitals.

Both measures were introduced as legislative proposals by the Resident Commissioner of Puerto Rico in Washington DC and presented to the bipartisan group composed of US Senators Bill Cassidy (R), Tim Scott (R), John Cornyn (R), Tom Carper (D), Mark Warner (D) and Robert Menéndez (D) at the beginning of the legislative session on August 14.

HHS can take administrative action in MA by proposing a meaningful step in enhancing MA rates in the upcoming MA 2025 Advance Notice. In parallel, we ask HHS to push for Congressional action to include specific language to end the exclusion of the MSP and Part D LIS to US citizens in Puerto Rico in legislation moving this year. As representatives of the health care industry on the Island, we are committed to collaborating with you to achieve meaningful changes to close inequities for Medicare beneficiaries this year.

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Medicaid and Medicare Advantage Association

MMAPA is a non-profit association dedicated to improving funding for Medicare Advantage and Medicaid beneficiaries and the healthcare system in Puerto Rico. Our mission is to ensure access to quality healthcare for all Puerto Ricans. Click here to learn more about our organization.

WHY WE NEED TO ADVOCATE

Medicaid and Medicare Advantage in Puerto Rico

Nearly 50% of Puerto Ricans live below poverty. 1.6 million benefit from MEDICAID, with 295,000 aged over 65 also using Medicare Platinum. Despite this need, Puerto Rico receives 50% less funds for Medicaid and 90% less for Medicare Platinum than the mainland U.S. This disparity affects service quality, beneficiaries' social security income, and provider compensation.

Solutions for Economic Disparity

To close the economic gap, we propose:

  • Adjusting the average geographic factor to infuse $1.5 billion extra funds.

  • Implementing the Medicare Savings Program in Puerto Rico, relieving financial burdens on the elderly.

  • Including the Medicare Part D Low-Income Subsidy to aid 400,000 citizens with prescription costs.

Human Impact of the Funding Gap

Financial disparities lead to human costs: denied/delayed treatments, added financial stress, limited access to vital medications, and potential brain drain of healthcare professionals. Every delay or denial has a direct, detrimental health impact on beneficiaries.

Moral Duty to Advocate

All U.S. citizens, including Puerto Ricans, deserve equal healthcare access. Denying this is a breach of rights and values. Ensuring healthcare equality in Puerto Rico upholds core U.S. principles of justice, equality, and the pursuit of a better life for all.

What Our Members Say

"I've been a member of MMAPA for years and I couldn't be happier with the care I receive. The personalized support and affordable health plans have made all the difference."

Maria Rodriguez

"As a small business owner, I appreciate the affordable healthcare options MMAPA offers. They've helped me provide quality healthcare to my employees without breaking the bank."

Juan Perez

"I highly recommend MMAPA to anyone looking for quality healthcare in Puerto Rico. Their team of experts is dedicated to finding the best healthcare solutions for your unique needs."

Ana Torres

Get In Touch

Contact us today to learn more about our organization and how we can help you access quality healthcare. You can also fill out the form below to schedule a free consultation with one of our experts.

123 Main Street, San Juan, PR 00901

(123) 456-7890

Thank You!

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