# Plain Language Summary: Supporting Medicaid in the U.S. Territories Act of 2021

This bill provides increased federal funding for Medicaid programs in U.S. territories—specifically Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Right now, these territories receive significantly less federal money for their Medicaid programs compared to the 50 states, even though they often have higher poverty rates and greater healthcare needs. This bill extends and increases that federal support through 2026 for Puerto Rico and through 2029 for the other territories.

The main impact is financial: the bill guarantees that these territories will receive higher levels of federal funding for their healthcare programs serving low-income residents. For example, Puerto Rico would receive approximately $2.7 billion annually through 2026, while other territories would receive between $60 million and $127 million per year through 2029. This money helps pay for doctor visits, hospital care, prescription medications, and other medical services for people who qualify for Medicaid. Without this bill, the funding would drop significantly after 2021, forcing territories to either cut services or find money elsewhere—which they typically cannot do.

The bill also includes accountability measures. Puerto Rico must implement a system to verify that people applying for Medicaid actually qualify based on their assets and income. Additionally, Puerto Rico must designate an official to oversee government contracts related to Medicaid, ensuring that money is spent properly and competitively. These oversight requirements are designed to prevent fraud and waste while the territories receive this increased support. The bill essentially says: "We'll give you more money, but you need to show us you're using it responsibly and following proper procedures."

Supporting Medicaid in the U.S. Territories Act of 2021

Soto, Darren

Supporting Medicaid in the U.S. Territories Act of 2021 This bill extends, increases, and otherwise modifies Medicaid funding for U.S. territories. Specifically, the bill extends (1) the temporarily increased Federal Medical Assistance Percentage (i.e., federal matching rate), and (2) a higher cap on Medicaid funding. Such provisions apply to Puerto Rico through FY2026 and to other territories through FY2029. The bill also requires Puerto Rico to implement an asset verification program and to report on its ability to comply with certain reporting requirements, procurement standards, and other Medicaid program integrity measures.