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Senator Warren, Colleagues Warn of Public Health Crisis in Puerto Rico, Urge HHS to Take Action

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Senators Request Emergency Support for Puerto Rico and U.S. Virgin Islands' Medicaid Programs and Assistance in Restoring Power to Local Health Centers

Oct 10, 2017

Text of the letter available here (PDF)

Washington, DC - U.S. Senator Elizabeth Warren (D-Mass.) joined Senators Bob Menendez (D-N.J.), Bill Nelson (D-Fla.), Kirsten Gillibrand (D-N.Y.) and nine other senators to call on the U.S. Department of Health and Human Services to provide additional resources and better coordinate efforts on the ground in the face of a growing public health crisis in Puerto Rico and the U.S. Virgin Islands following Hurricanes Irma and Maria to ensure that the more than 3.5 million Americans citizens living there can safely access the quality health care they need.

"Even before Hurricanes Irma and Maria hit the U.S. territories, the islands' health care system was suffering from the ongoing economic crisis. The islands are grappling with physician shortages, Medicaid programs facing an impending funding cliff, and widespread disparities in Federal health programs-and that was before hurricane season," the senators wrote in a letter to Acting Health and Human Services Secretary Don Wright.  "We are grateful for the public health emergency declaration in Puerto Rico and the U.S. Virgin Islands, but more can and should be done to help Americans impacted by these disasters."

The letter stressed that much of the islands' power and communication networks are out and, according to the Federal Emergency Management Agency (FEMA), it will take months before power is fully restored.  Only 17 hospitals in Puerto Rico have electricity, and the two hospitals on the Virgin Islands have been severely damaged.  Hospitals have been forced to prioritize patients, ration services, and forgo elective surgeries.

At least 40 lives have been lost, and with scant resources, 100-degree temperatures, and abundant standing water increasing the breeding grounds for disease-carrying mosquitos, there is growing concern the death toll could rise without greater assistance.

"Given the devastation we described, we ask you to provide the necessary support to meet the immediate needs of Puerto Rico and the U.S. Virgin Islands, as well as provide long-term relief," the senators continued.  "It is imperative that we do all we can to prevent a large-scale public health crisis from developing by providing the high-level coordination and stewardship of federal resources."

The letter urged the administration to provide not only immediate relief to the islands but long-term relief as well, as the islands begin to recover. Specifically, the letter requests necessary funding and emergency support for the islands' Medicaid programs along with assistance in coordinating and prioritizing electric restoration to hospitals, health clinics, nursing homes, and pharmacies.

As leading voices in Congress to help prevent the collapse of the islands' health care system, the senators argued that the U.S. territories' "Medicaid cliff" will be exacerbated by the recent disasters. In Puerto Rico and the Virgin Islands, the Medicaid program is subject to a block grant that will cap funding during recovery regardless of the greater demand.

"While the territories' Medicaid programs received a one-time increase of $7.3 billion in federal funding to last through 2019, they are spending it at a faster rate than anticipated, with needs only expected to expand in the aftermath of these storms," the senators wrote.

Senators Cory Booker (D-N.J.), Edward Markey (D-Mass.), Tammy Baldwin (D-Wisc.), Chris Van Hollen (D-Md.), Richard Blumenthal (D-Conn.), Kamala D. Harris (D-Calif.), Martin Heinrich (D-N.M.), Tim Kaine (D-Va.), and Sherrod Brown (D-Ohio) also signed the letter.

Since Hurricane Maria ravaged the island, leaving behind historic devastation, Senator Warren has joined her Senate colleagues in urging President Trump to take action in response to the crisis in Puerto Rico and the U.S. Virgin Islands, and has called on him to use his authority under the Defense Production Act to more swiftly respond to the disaster.  She has also written to Republican leadership requesting that Congress be allowed to promptly take up legislation to provide the necessary aid to the U.S. citizens living on the islands.  Senator Warren has previously joined in calling for President Trump to waive the local cost-sharing requirement for the hurricane response in Puerto Rico and the U.S. Virgin Islands and for the federal government to fully cover recovery expenses, noting the challenging fiscal situation and extensive damage in both jurisdictions in calling for the waiver.  Last week, she urged the White House to step up disaster recovery efforts on the Puerto Rican islands of Vieques and Culebra after the islands were devastated by Hurricanes Irma and Maria.

The full text of the letter can be found here.

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