Dear Senator:

I am writing to you in support of the inclusion of all U.S. citizens in the current health reform legislation. When I say all U.S. Citizens, I am referring to those who live in the 50 states as well as in Puerto Rico and other territories.

It is time to eliminate the inequities facing Americans who live in Puerto Rico! President Barack Obama is well aware of these inequities. That is why he pledged for equal coverage for Puerto Rico in all federal health care programs in an open letter to the Governor of Puerto Rico on January 2, 2009.

Since World War I, U.S. citizens from Puerto Rico have fought together with our fellow Americans in every conflict for the cause of freedom. We have shed blood for our Nation and we will continue to do so in defense of democracy and freedom. Over 100 Puerto Ricans have died in Iraq and Afghanistan since 2001; numerous others have been wounded and/or decorated for their valor. If we can be equal to all Americans when it comes to making the ultimate sacrifice for our Nation, why can’t we be equal in health coverage?

I respectfully request that you allow the residents of Puerto Rico to be eligible for the insurance exchanges on an equal basis, as the residents of the states. All aspects of the insurance provisions should apply to Puerto Rico: the insurance and consumer reforms, the requirement for individuals to obtain coverage, and the affordability provisions. This would guarantee basic health coverage for over 400,000 residents of the Island who lack health insurance.

I also urge you to eliminate the current disparities in the Medicaid program applied to Puerto Rico and other territories by lifting the current caps and increasing the federal matching payment. Currently, federal contributions to the territories are arbitrarily capped and federal payments are made at a fixed 50-50 rate.

In addition, I call for providing 100% Prospective Payment System under the Medicare program to Puerto Rico. At present, the Medicare program reimburses hospitals in Puerto Rico below cost in spite of the fact that local hospitals face identical cost pressures and regulatory mandates as hospitals in the mainland.

Furthermore, I ask for your support to provide residents of Puerto Rico automatic enrollment in Medicare Part B. Puerto Rico is the only jurisdiction where seniors are not automatically enrolled in Medicare Part B. As a result, our seniors have the lowest participation in Medicare Part B in the country and higher out-of-pocket costs.

I will appreciate your help on eradicating these serious inequities faced by the U.S. citizens living in Puerto Rico and hope you will support the above provisions in the health care reform legislation.

Sincerely,