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WASHINGTON — As Democrats close in on the biggest overhaul of the Medicare prescription drug benefit in 20 years, they’re ignoring a glaring health equity issue: unequal treatment for low-income adults 65 and older in Puerto Rico.

Residents of Puerto Rico pay the same Medicare taxes as other Americans, but they’re eligible for less help than other older adults when it comes to paying for their pharmacy drug premiums and their prescription drug costs. For all Democrats’ talk about health equity this Congress, they haven’t incorporated a bill that would level the playing field.


Right now, only adults 65 and older making below 75% of the federal poverty level, or $10,219 a year, are eligible for extra help in Puerto Rico. If the same patient lived in a state like Florida, they’d qualify even if they made up to 150% of the poverty level, or $20,385. One group representing insurers in the territory estimates that roughly between 120,000 and 150,000 people fall into that subsidy gap now.

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