Puerto Rico Residents Say Feds Shortchanging Them on Health Care

(CN) - Ten residents of Puerto Rico claim in court that the federal government is discriminating against U.S. citizens who reside in the island by providing them with fewer health care benefits than to those offered to residents in any of the 50 states.

In a federal complaint filed in the Miami on Friday, the plaintiffs say that U.S. citizens living in Puerto Rico are currently suffering the challenges and consequences caused by devastating hurricanes, including the loss of many of their basic services.

Hurricane Maria swept across the island in September, and many residents are still without running water and permanent shelter, and thousands of businesses remain closed.

“Even before Hurricane Maria’s devastation, it was dangerous to get sick in Puerto Rico due to a decade-long recession and a fiscal crisis that forced hospitals to suffer through electricity and water shortages and to delay and prioritize payments to provide basic care for their patients,” the plaintiffs say.

On June 30, 2016, the U.S. Government passed the Puerto Rico Oversight, Management and Economic Stability Act or PROMESA to help alleviate, renegotiate and restructure the public debts which amounts to about $70 billion.

The plaintiffs, who are represented by Rafael Escalera-Rodriguez, of Reichard & Escalera LLC in Puerto Rico, say that even though more than half of the population in the island lives in poverty “federal statutory and regulatory provisions explicitly exclude U.S. citizens in Puerto Rico from receiving the same federal benefits given to fellow U.S. citizens of equal need …”

According to the complaint, federal law has excluded Puerto Rico residents from receiving Supplemental Security Income or SSI, the Supplemental Nutrition Assistance Program or SNAP and certain low-income subsidies deriving from Medicare.

The complaint says that these programs ensure that U.S. citizens have access to health care services, but they also discriminate against U.S. citizens residing in Puerto Rico.

The SSI is a federal income supplement program that aids the aged, blind and disabled individuals that have little or no income, and it’s available to all U.S. citizens except those living in Puerto Rico.

On the other hand, SNAP is a federal program that provides nutrition assistance to low-income households nationwide through an “Electronic Benefit Transfer” card, and it’s administered by the Food and Nutrition Service of the U.S. Department of Agriculture, the complaint claims.

“Federal law excludes U.S. citizens in Puerto Rico from receiving SNAP benefits,” the complaint says.

Instead of SNAP Puerto Rico currently uses a federal block grant to fund its own Nutrition Assistance Program that offers fewer benefits.

The complaint alleges that the Medicare, which was enacted in 1965 and was designed to help the elderly and disabled, offers different Medicare Advantage plans.

“The Medicare statute expressly treats U.S. citizens who live in Puerto Rico differently and less advantageously than citizens in States in a variety of ways,” the complaint says.

The complaint claims that for instance Medicare beneficiaries in Puerto Rico are not eligible to receive the “low income subsidy,” which is given to low-income individuals living in any of the 50 states and the District of Columbia.

In 2014 the U.S. Government Accountability Office published a report on the federal funding disparities impacting Puerto Rico that estimates that if Puerto Rico were treated the same than any state in the U.S., the island would receive up to $4 billion in additional annual federal funds, the lawsuit says.

“… Extending federal benefits for SSI, SNAP and Medicare would greatly improve the financial health of Puerto Rico residents by ensuring that all U.S. citizens who live in Puerto Rico have financial, medical and nutritional security equal to that of U.S. citizens living in the fifty United States or the District of Columbia,” the complaint says.

Plaintiffs are seeking declaratory and injunctive relief on claims of violations of the Equal Protection Clause.

A representative from the U.S. Department of Health and Human Services and the Social Security Administration failed to respond to email and phone requests for comment on the litigation.

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