Hurricane Maria hit on September 20th, less than two weeks after Hurricane Irma hit on September 6, 2017, causing significant physical damage to the infrastructure (including health care infrastructure) in Puerto Rico and the US Virgin Islands (USVI). These hurricanes left major challenges for residents and severe economic damage and health consequences in their wakes. The problems wrought by the storms exacerbate pre-existing fiscal and health challenges faced by these territories. One of the major financing issues for the territories is how to respond given the cap on federal Medicaid financing coupled with the end of the additional funding provided through the Affordable Care Act (ACA). This brief identifies key issues and short and long-term options for recovery in Puerto Rico and USVI drawn from research and from a November 30th roundtable discussion held at the Kaiser Family Foundation in Washington, DC with individuals representing a variety of perspectives on Medicaid policy, health insurance and care delivery systems, and disaster recovery. The roundtable discussion was focused on Medicaid's role in Puerto Rico and USVI and as part of the hurricane recovery efforts.
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