June 14, 2021

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More people with access to health services | government


Up to 270,00 people unprotected from a health services plan could benefit from the coverage of the Vital Plan, after the Department of Health received authorization from the Centers for Medicare and Medicaid Services (CMS for its acronym in English) to increase the income scale of the participants.

They are the group of people whose income – even when they are on the poverty line – did not allow them access to government health coverage, but they also did not earn enough to pay for private coverage.

The number of people benefited is a “maximum” estimate that was made and would include a sector of the population whose poverty level has increased, said the executive director of the Health Insurance Administration (ASES), Jorge Galva, in an interview with THE SPOKESMAN.

Galva described the announcement as “an achievement” and understands that now “Puerto Rico is definitely placed in the jurisdiction with the largest number of insured persons.”

“We are reaching a quota that exceeds 90%, it is an immense achievement,” he said.

However, the benefit was not achieved permanently because as of September 30, 2021, the coverage with this type of scale will expire. Currently, Plan Vital covers 1.3 million lives.

In the summer budget message, Governor Wanda Vázquez promised that she would seek to add up to 200,000 people to the Vital Plan and in mid-October the Fiscal Control Board authorized the spending for temporary access. The new ad includes more people.

They will fight in Congress

Both Galva and the director of Medicaid Puerto Rico, Luz Cruz, indicated that they will fight “the battle in Congress” to increase the federal contribution and achieve an extension – or permanence – of the scale in this coverage.

“It has been discussed with the outgoing Health Secretary (Lorenzo González) and the designated (Carlos Mellado) and with the committee of members of the elected governor (Pedro Pierluisi),” Galva reported.

While the director of Medicaid said: “We have been working hard over the past months to move up the income ladder. It could not be achieved permanently, the Board (of Fiscal Control) did not authorize it like this (…) We are going to be fighting that fight in Congress to increase the federal contribution. The commitment of the incoming government administration is to bring that message to Congress. “

An act of “social justice”

According to the data provided, now individuals who earn $ 1,202 per month will be eligible for the Vital Plan. While for the household with two people, the eligible income increases to $ 1,604; the one for three people at $ 2,046 and the one for four at $ 2,468.

In the case of a family with children – even if the parents were not eligible – the minors could be, since under the CHIP Program, the income level to qualify is even higher.

“This is an achievement of social justice for a sector of our people whose poverty level has increased,” explained Galva. “For those who had a higher income and could not apply, but could not afford a health plan,” he added.

A temporary relief

Linda Colón, a sociologist and expert on poverty issues, agreed that it is a “temporary relief.”

“The poverty line (wages) is around a thousand something and 12 thousand or 13 thousand annually. This scale of $ 1,200 (per individual) includes a sector that is not normally under the poverty index for very little money on a monthly basis, “said Colón to THE SPOKESMAN.

“In this sense, it increases the possibility that this group that does not fall under the poverty line —but lives in poverty conditions— is included because there was an extension of funds. This is a temporary relief that in a year or so is going to end and makes it possible for a part of that sector to enter, “he said.

Pandemic crisis leaves its mark

The executive director of ASES admitted that the Covid-19 pandemic triggered the applications to obtain the Vital Plan.

“From May to now we saw a significant increase in applications,” he said. Many of these cases by people who went to try their luck for work in the United States and – when they were unemployed – returned to Puerto Rico.

Also other Puerto Rican families, whose income on the island decreased, have requested coverage.

“We are receiving a statistically significant change, thereby reversing the downward trend that we had seen since mid-2019, mostly associated with migration,” said Galva.

Compared to September 2019 to September 2020, there has been an increase of 35 thousand more people who have applied for program coverage.

The director of Medicaid Puerto Rico called on citizens who request the program to be aware of their cell phone and email.

“We are encountering the situation that when we call the applicant to clarify information, they do not answer us. They see it as an unknown or private number. Information is also sent to their e-mail and they do not reply back to us because perhaps it reaches the ‘junk’ or ‘spam’ (folder). We urge that everyone who requests is monitoring their mail and that if they call you from an unknown number, it can be us, “he said.

To apply for the Vital health plan, you must access the website, www.medicaid.pr.gov.



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