Press Room

U.S. Territories Face Healthcare Cuts if Congress Does Not Address Impending Medicaid Financing Cliff

ARLINGTON, VA (May 23, 2019)—Association of State and Territorial Health Officials (ASTHO) member Esther Muña, MHA, chief executive officer at the Northern Mariana Islands Commonwealth Health Corporation, and other territorial health leaders from Guam, Puerto Rico, America Samoa, and the U.S. Virgin Islands testified today before the United States House Committee on Natural Resources about the impact that cuts to Medicaid would have on U.S. territory populations.

“On the heels of Super Typhoon Yutu, which devastated the Commonwealth of the Northern Mariana Islands’ economy and its people, we face another crisis – our Medicaid program is unable to sustain its operations with the low statutory cap on federal contributions,” says Muña. “Low federal contributions, coupled with the exhaustion of the Patient Protection and Affordable Care Act funds this year, creates a fiscal cliff for our Medicaid program. This fiscal cliff threatens to unweave our substantial improvements over the past ten years in the delivery of healthcare, further erodes our economy, and threatens the health and well-being of our people.

“I strongly urge Congress to stabilize Medicaid financing for the territories by raising or eliminating the arbitrary cap on federal dollars to the program so I can continue my work to protect and promote the health our population,” Muña continues.

Unless Congress acts, the U.S. territories’ Medicaid programs will become gravely underfunded. Federal funding for Medicaid in territories is capped and it is subject to a fixed federal matching rate.

For more information about the hearing, visit the committee’s website.


ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and the District of Columbia, 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