On the Outskirts of National Health Reform: A Comparative Assessment of Health Insurance and Access to Care in Puerto Rico and the United States

The Milbank Quarterly
Maria Portela, Benjamin D Sommers

Abstract

Puerto Rico is the United States' largest territory, home to nearly 4 million American citizens, yet it has remained largely on the outskirts of US health policy, including the Affordable Care Act (ACA). We analyzed national survey data from 2011 to 2012 and found that despite its far poorer population, Puerto Rico outperforms the mainland United States on several measures of health care coverage and access to care. While the ACA significantly increases federal resources in Puerto Rico, ongoing federal restrictions on Medicaid funding and premium tax credits in Puerto Rico pose substantial health policy challenges in the territory. Puerto Rico is the United States' largest territory, home to nearly 4 million American citizens. Yet it has remained largely on the outskirts of US health policy, including the Affordable Care Act (ACA). This article presents an overview of Puerto Rico's health care system and a comparative analysis of coverage and access to care in Puerto Rico and the mainland United States. We analyzed 2011-2012 data from the Behavioral Risk Factor Surveillance System, and 2012 data from the American Community Survey and its counterpart, the Puerto Rico Community Survey. Among adults 18 and older, we examined healt...Continue Reading

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Citations

Oct 5, 2018·CA: a Cancer Journal for Clinicians·Kimberly D MillerRebecca L Siegel
Dec 29, 2019·International Journal of Environmental Research and Public Health·Hanna B DemekeLinda Beer
Oct 10, 2020·Journal of Racial and Ethnic Health Disparities·Pearl A McElfishMohammed F Faramawi
Sep 22, 2021·CA: a Cancer Journal for Clinicians·Kimberly D MillerRebecca L Siegel

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