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The Insufficiency Of Medicaid Block Grants: The Example Of Puerto Rico

This aerial photo shows buildings still surrounded by flood water, a week since the passing of Hurricane Maria, in San Juan, Puerto Rico, Wednesday, Sept. 27, 2017. Maria was the strongest hurricane to hit Puerto Rico in nearly 100 years and officials say the cost of recovery will dwarf that of the punishing Hurricane Georges in 1998. (AP Photo/Ramon Espinosa)
Medicaid block grants have been a centerpiece of Republican health proposals for more than a decade. Proponents, including House Speaker Paul Ryan (R-WI), argue that giving states a fixed amount of money through a block grant or per-person limit with few strings attached gets Washington out of the way and allows for state innovation. Although the most recent block grant legislation did not reach the Senate floor, proponents have promised to continue to push for it. But one need look no further than the growing health crisis in Puerto Rico to understand why capped federal money and state flexibility will not solve serious health care issues. Puerto Rico Has Been A Laboratory For Block Grants Unlike states, Puerto Rico’s federal Medicai ...
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