ASTHO and NAMD Call on Congress to Fully Fund Medicaid and CHIP in U.S. Territories

June 18, 2024

ARLINGTON, VA—In a joint letter to Congress, the Association of State and Territorial Health Officials (ASTHO) and the National Association of Medicaid Directors (NAMD) urged Congress to fully fund Medicaid and Children's Health Insurance Programs (CHIP) in the U.S. territories. ASTHO and NAMD request that Congress lift the annual Section 1108(g) allotment cap for all territories and authorize a permanent 83% Federal Medical Assistance Percentage (FMAP) for Puerto Rico.

“ASTHO recognizes the importance of permanent, sustainable, and equitable Medicaid financing for all U.S. territories,” says Joseph Kanter, MD, MPH, ASTHO CEO. “ASTHO respectfully requests Congress make changes to territorial Medicaid funding structures to help our nation’s territories ensure the same access to essential public health and healthcare services available to citizens in mainland United States.”

“Unlike the states, the U.S. territories face an annual cap on their Medicaid funding,” says Kate McEvoy, Executive Director of NAMD. “This has impaired the territories’ capacity to provide needed health care to Medicaid-eligible U.S. citizens and nationals. It has also held the territories back from making the structural investments in care delivery and value-based payment reform, workforce, IT systems, and program integrity that are crucial to high performing and innovative Medicaid programs.”

Chronic underfunding has impaired territories’ capacity to serve the needs of their residents, who are U.S. citizens or U.S. nationals. By acting today, Congress can improve health and ensure equity for all. Learn more in the joint letter.

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ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and Washington, D.C., as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.

NAMD is a professional community of state and territory leaders who provide health insurance to almost 90 million individuals and families through Medicaid and the Children’s Health Insurance Program in each of the 50 states, the District of Columbia, and the U.S. Territories. NAMD elevates thought leadership on core and emerging policy matters, amplifies the experience and expertise of Medicaid and CHIP directors, supports state programs in continuous improvement and innovation, and optimizes federal-state partnerships to help millions live their healthiest lives.