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Avoiding the Cliff: Financing Medicaid in the Territories

July 29, 2021

Medicaid plays a critical role in providing access to health services for low-income U.S. citizens in the five U.S. territories. However, Medicaid financing in the territories has been underfunded compared to states. While Congress has provided a patchwork of short-term, enhanced funding solutions through recent appropriation bills, they are set to expire at the end of September, which could trigger a “Medicaid cliff” and result in drastic cuts to territorial Medicaid programs.

Today’s guests discuss the urgent need for a permanent Medicaid solution, drawing attention to the need for equitable health financing for the U.S territories. This funding is necessary to support comprehensive public health and healthcare within these jurisdictions that include expanded prevention, testing, and treatment programs and capabilities.

Show Notes


  • Karl Ensign, MPP, Vice President, Territorial Support, Association of State and Territorial Health Officials
  • Justa Encarnacion, RN, BSN, MBA, Commissioner of Health, U.S. Virgin Islands Department of Health
  • Jorge Galva, JD, MHA, Executive Director, Puerto Rico Health Insurance Administration