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Sunday, June 5, 2011

Pierluisi Seeks to Obtain the Same Preventive Care Services for Breast Cancer and Cervical Cancer Patients in Puerto Rico that the 50 States Can Provide Under Medicaid


Washington, DC- Resident Commissioner Pedro Pierluisi introduced a bill today that seeks to amend federal law to allow the Government of Puerto Rico to provide the same level of preventive care and treatment services under Medicaid for breast cancer and cervical cancer that the 50 States and the District of Columbia can provide.

For the residents of the 50 States and the District of Columbia, there are no limits on the federal payments for Medicaid, provided that the participating State is able to contribute its share of matching funds. The federal government subsidizes between 65% and 80% of the costs in the 50 States, depending on individual state per capita income level as compared to the national average. This is not the case in Puerto Rico and the other U.S. territories.

“There is a statutory cap on annual federal funding for Medicaid in the territories and the costs incurred by preventive testing for breast cancer and cervical cancer count toward the statutory cap. The bill I am introducing seeks to improve this unacceptable situation by amending federal Medicaid law so that federal payments for preventive care and treatment for breast and cervical cancer do not count towards a territory’s statutory cap,” said Pierluisi.

Under current law, the States and territories are authorized—but not required—to include preventive care and treatment for breast and cervical cancer as a covered service under their Medicaid programs. If a State elects to offer this as a covered service under their Medicaid program, they are eligible to receive a minimum federal match rate of 65%, which is the case for wealthier states, and over 80% in the case of poorer states. If a territory elects to cover the services and if such costs were to fall under the spending cap, the federal government based on current law would only share 65% to 68.5% of the costs incurred. If the costs exceed the spending cap, then the federal government would pay nothing under current law.

“Every single state and D.C. has formally elected to provide this optional coverage, but the U.S. territories are constrained in their ability to fully provide for this optional service under their Medicaid programs. The reason is simple. Because of the federal funding caps, no territory has been able to afford to do so without displacing federal payments for other Medicaid services and beneficiaries. As a result, low-income women on Medicaid in the territories cannot access this critical care under terms equivalent to those in the 50 States and D.C.,” said Pierluisi.

Because of this reality, explained the Resident Commissioner, low-income women residing in the territories cannot access these critical services in the same manner as in the 50 States.

Under the bill introduced by Pierluisi, H.R. 2135, the Breast and Cervical Cancer Prevention and Treatment Improvement Act of 2011, Puerto Rico and the other territories would be eligible for the same federal contribution that other states receive. In Puerto Rico’s case, that amount is slightly over 80% of the cost of service. In other words, every 20 cents spent by Puerto Rico’s government to provide mammograms and other care would be matched by 80 cents from the federal government.

“This bill will improve access to needed preventive health care services and treatment in Puerto Rico and the other territories for women facing a diagnosis of cancer. The Mi Salud program is an important means by which women who cannot afford this treatment can receive it. Our Medicaid programs in the territories should be able to offer this coverage with federal support, just as it is offered to women enrolled in Medicaid programs in the 50 States,” said Pierluisi.

The bill is cosponsored by Representative Debbie Wasserman Schultz (D-FL)—a breast cancer survivor—and Reps. George Miller (D-CA), José Serrano (D-NY), Donna Christensen (D-VI), Madeleine Bordallo (D-GU), Eni Faleomavaega (D-AS), and Gregorio Kilili Camacho Sablan(D-CNMI).