Puerto Rico, whose leaders have complained of unequal federal treatment on healthcare, may get some help from the state with the most Puerto Rican citizens outside the island itself - New York.
New York Governor Andrew Cuomo visited the U.S. commonwealth on Tuesday, presenting a plan to assist Puerto Rico in seeking federal investment to overhaul its healthcare system, and to pressure the U.S. government to change healthcare funding formulas.
As Puerto Rico struggles under $72 billion in debt, its fate has become a talking point for many U.S. politicians, especially in New York and Florida, which have high Puerto Rican voting constituencies.
Cuomo, who led a delegation of New York leaders to the Caribbean island, said in a Tuesday statement the trip was "about fighting to achieve fairness and parity for Puerto Rico," whose 3.5 million residents are ineligible for the federal health insurance exchange, even as insurers on the island pay $1.85 million a year in Affordable Care Act taxes.
Leaders in New York, home to more than 1 million Puerto Ricans, will pressure federal officials to change funding formulas and to replenish the island's healthcare block grant, Cuomo said.
New York Department of Health officials will help Puerto Rico form a plan to transform its healthcare delivery system, as New York did in 2011, as part of an application to the federal government for money to help with the overhaul, Cuomo added.
Puerto Rico Governor Alejandro Garcia Padilla, who invited Cuomo to the island's capital, San Juan, said in the statement, "The fiscal sustainability of Puerto Rico depends in no small part on Washington providing equitable healthcare treatment."
Healthcare represents some 20 percent of a Puerto Rican economy saddled with $72 billion in debt.
Presidential candidates Hillary Clinton and Marco Rubio visited Puerto Rico on Friday, with Clinton, a Democrat, addressing a healthcare panel and citing the "unfortunate legacy of inconsistent" and "inequitable treatment of healthcare" on the island.
New York City Council Speaker Melissa Mark-Viverito, a Puerto Rican and a member of Cuomo's delegation, said she believes the New York governor's plan is politically attainable.
In an interview on Tuesday, she cited the high Puerto Rican population in Florida, a key battleground state in next year's presidential election.
"If the president can make this a priority, if we can get this discussed in budgeting debates - we just have to be united."