Washington, DC — Congressman Michael C. Burgess, M.D. (R-TX), Republican Leader of the Energy and Commerce Subcommittee on Health, gave the below opening remarks at today’s  Energy and Commerce Subcommittee on Health hearing “Strengthening Health Care in the U.S. Territories for Today and Into the Future.”

Dr. Burgess’ Remarks as Prepared for Delivery

Thank you, Madam Chair. During our last extenders hearing two weeks ago, I noted that we had left out an incredibly important piece of the conversation – Medicaid in U.S. Territories. I would like to thank Chairwoman Eshoo for her commitment to hold this hearing, and I would especially like to thank the representatives from each of our nation’s territories for traveling such distances to be here today. I would also like to recognize Representative Jenniffer Gonzalez-Colon from Puerto Rico and Representative Aumua Amata Coleman Radewagen from America Samoa who are waiving onto our Subcommittee for this hearing.

The five U.S. territories, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands, each have a vulnerable population that depends on Medicaid and the Children’s Health Insurance Program. The structure of these programs is different than those of the individual states; however, these programs are equally important, as these are United States citizens. The funding for Medicaid in some of the territories was last reauthorized in the Bipartisan Budget Act of 2018, but that funding is set to expire at the end of this September. It is critical that we act in a timely manner to reauthorize this funding.

Over the course of the past few years, the territories have suffered tremendous damage from natural disasters, including hurricanes and typhoons. What are already at-risk populations have been made more vulnerable as they have suffered destructions of their homes and infrastructure, and in some cases, health care professionals have left the territories for mainland United States.

As the territories continue to recover and prepare for potential future devastation, we need to be mindful of their inhabitants’ access to health care, and ensuring adequate Medicaid funding is integral in maintaining that access.

As Dr. Schwartz points out in her testimony, the territories have sufficient funding to cover their expenses through the end of this fiscal year, however it is the long-term challenge that we are facing today. I also think it is worth noting that Puerto Rico has by far the most enrollees and faces challenges that are not necessarily relevant to the other territories. As we move forward in the process of extending Medicaid funding for all of the five territories, we must remember that each territory is unique and requires a different approach in our legislation.

Each territory has different benefits for its citizens, and only Puerto Rico uses Medicaid managed care, while the other territories operate fee-for-service systems.

While it is critical to ensure adequate funding for the territories to operate their Medicaid programs, I also believe that it is important to have appropriate accountability measures and fraud detection and prevention. For our own states, the House passed a permanent reauthorization of Medicaid Fraud Control Units earlier this week, and we should hold the territories to a similar standard – especially if increased funding is provided in September. As we saw in Puerto Rico following the enactment of the Bipartisan Budget Act of 2018, it is possible for the territories to adopt and successfully implement program integrity measures.

I hope that we can use this hearing as an opportunity to have a productive conversation about any potential changes to the federal payment mechanisms in Medicaid programs in the territories. We are willing to engage on this issue, but we need to strike the right balance between funding and structuring these programs such that they can succeed and being good shepherds of taxpayer dollars.

Again, I would like to thank all our witnesses for being part of this important conversation today. I yield back.

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