GOP leaders were unable to find 60 votes for this inadequate bill. The solution is right in front of us: The House has approved a disaster funding bill that includes these critical pieces of funding. Policymakers must act now to address the mounting suffering in Puerto Rico and the coming health-care crises in the Pacific territories. To avoid further delay, the Senate should adopt the House approach to meeting these needs and Congress should include it in a final disaster bill.
Even before Hurricanes Irma and Maria devastated Puerto Rico in late 2017, poverty and hunger were far more common there than anywhere else in the United States. More than 1 million people in Puerto Rico were food insecure, meaning they sometimes didn’t have access to affordable, nutritious food — including a whopping 56 percent of Puerto Rico’s children, which is more than three times the rate of food insecurity among families with children elsewhere in the United States.
Making matters worse, Puerto Rico’s Nutrition Assistance Program (NAP) operates fundamentally differently than the Supplemental Nutrition Assistance Program, or SNAP (formerly called food stamps) — to the detriment of Puerto Rico residents. Under SNAP, which operates in every state and the U.S. Virgin Islands and Guam, everyone eligible who applies receives benefits. So, the program expands automatically in response to immediate needs after a disaster and to rising levels of poverty and unemployment.
Under NAP, however, Puerto Rico receives capped funding of about $2 billion a year. That’s not enough to meet Puerto Rico’s nutritional needs under ordinary circumstances — much less after two hurricanes. It’s far less than what the commonwealth would receive if NAP operated like SNAP.
After the two hurricanes, policymakers provided significant funding in October 2017 to enable Puerto Rico to raise NAP benefits and expand the number of people eligible for it. Unfortunately, these funds are now depleted, and NAP benefits have returned to previous low levels.
Anticipating that would occur, Gov. Ricardo Rosselló in November requested an additional $600 million to maintain NAP benefits at the more adequate levels for about six more months. The House approved the request more than two months ago but, because the Trump administration opposed the House package, the Senate didn’t include the NAP funding in February’s spending bill to keep the government open.
Then, the administration agreed to support a Senate disaster bill that included the NAP funding. But, again, the Senate didn’t act before leaving for its March recess and, as a result, about 1.35 million people — more than one-third of Puerto Rico’s population — lost some 35 to 40 percent of their food-assistance benefits last month, including more than 300,000 children. Benefits will remain at these reduced levels until policymakers enact additional disaster relief.
Over the long run, the nation’s leaders should restructure NAP so that it operates like SNAP. For now, however, Puerto Rico needs the additional infusion of money to prevent more of its people from going without enough to eat.
As for Guam, the Northern Mariana Islands and American Samoa — all of which suffered widespread destruction from disasters last year — they and the other territories suffer from a similar problem in Medicaid that Puerto Rico does in NAP.
Unlike the states, where federal funding covers a specified share of their Medicaid funding, the territories receive a fixed amount of federal funding each year. Even under normal circumstances, that funding is inadequate to address their needs.
The territories have avoided cutting their Medicaid programs in recent years because they received added federal funds through the Affordable Care Act, beginning in 2011. But the Northern Marianas has exhausted its ACA funds this year, and Guam and American Samoa can’t provide the matching funds needed to draw down theirs. American Samoa is struggling to find funding for its medical center — the island’s only Medicaid provider — which cares for almost all of the territory’s residents. (Three-quarters of American Samoans qualify for Medicaid.)
Thus, the House bill’s funding is critical for the Pacific Island territories to sustain their Medicaid programs through the fiscal year. Policymakers will subsequently need to address Medicaid shortfalls for all of the territories (including Puerto Rico and the Virgin Islands) later in this calendar year.
As the richest nation on Earth, we surely can provide the funds to prevent millions of our fellow Americans from suffering unnecessarily. But we need our elected officials in Washington to act.