Congressman Faleomavaega announced today that to reduce health disparities in the Territories and to improve public health the Territorial Delegates have joined together in sending a joint letter to the House and Senate leadership requesting support for adjusting the statutory-set federal medical assistance percentages (FMAPs) for Medicaid expenditures and to raise the statutory spending caps.

The full text of their letter which was sent to Speaker Nancy Pelosi, Majority Leader Hoyer, Majority Whip Clyburn, Chairman Emanuel of the House Democratic Caucus, Chairman Dingell of the Committee on Energy and Commerce, Chairman Pallone of the Subcommittee on Health, Senate Majority Leader Harry Reid, and Chairman Max Baucus of the Senate Committee on Finance is included below.  

We write to respectfully request your support for adjusting the statutory-set federal medical assistance percentages (FMAPs) for Medicaid expenditures in the territories as part of an economic stimulus package or any other legislation affecting Medicaid that may come to the floor before the sine die adjournment of the 110th Congress.  As preparations for a possible second economic stimulus packages are undertaken, we strongly urge you to include language to increase the FMAPs and to raise the statutory spending caps for American Samoa, Guam, Puerto Rico, the Virgin Islands, and the Commonwealth of the Northern Mariana Islands.

The FMAPs for each of these jurisdictions are set by statute at the minimum level of 50% and are not determined by formula based on per capita income as is the case for the 50 states (42 U.S.C 1396d(b)(2)).  Additionally, federal Medicaid funding per fiscal year for each of the territories is subject to a spending cap set by statute (42 U.S.C. 1308).  This situation is resulting in disparities in treatment and care for Americans residing in the territories and is adversely impacting public health in our communities.  It also results in a disproportionate share of indigent care being borne by the local treasuries of the territories.  The territorial governments are operating with decreasing revenues and public health should not be compromised in a challenging fiscal environment.

Medicaid is a federal-state program and the territories, no less than the states, deserve federal assistance to reduce health disparities and to provide for public health.  The Deficit Reduction Act of 2005 raised the ceiling amounts affecting Medicaid funding for the territories.  Access to this new funding is hindered by the extraordinarily low and inadequate FMAPs.  We ask that you consider either allowing for the FMAPSs for the territories to be calculated in the same manner as done for the 50 states under current law or to adjust them to a more appropriate percentage for the next several fiscal years.  Additionally, we ask that you provide for increases to the statutory spending caps to account for the unique circumstances in each territory.

The Members closed their letter by stating, “Thank you for your consideration of our request as the leadership shapes economic stimulus and health care related legislation for the remaining days of the 110th Congress.