14 House Republicans Urge Medicare Advantage Payment Action for Puerto Rico

Fourteen Republican members of the U.S. House are urging the Trump Administration to take administrative action on Medicare Advantage payments in Puerto Rico, where more than 681,000 beneficiaries rely on the program and enrollment is the highest in the nation. Led by Rep. Greg Murphy, Chairman of the House Republican Doctors Caucus, the lawmakers are asking HHS and CMS to establish a minimum payment floor beg

inning in 2028, bringing Puerto Rico to the level currently provided to the U.S. Virgin Islands.

Why it matters: Puerto Rico offers a unique Medicare Advantage case study for federal policymakers: 96% of Medicare-eligible beneficiaries choose MA and 100% are enrolled in plans rated 4.5 stars or higher by CMS, yet payment levels remain approximately 41% below the national average. The congressional request comes at a critical time, as CMS is currently developing the proposed Medicare Advantage rule for 2028, creating an opportunity for the Administration to incorporate this policy change into the upcoming rule. The outcome could also have broader implications for how Medicare Advantage payment policy supports high-performing, high-penetration markets while maintaining program sustainability.