Trump personally stepped in to cut health funding for Puerto Rico in new spending deal, report says

President reportedly pulls majority of Medicaid funding from US territory despite congressional leaders reaching bipartisan agreement

Donald Trump stepped in to cut Medicaid funding for Puerto Rico by more than half of the original amount that was agreed to during bipartisan negotiations, according to a new report.

Republican and Democratic leaders agreed to provide the US territory with $12bn (£9.2bn) over the next four years as part of a $1.4tn (£1.07tn) spending bill, averting another government shutdown and sending crucial health funding to Puerto Rico after it was ravaged by Hurricane Maria two years ago.

Puerto Rico has continued rebuilding itself after the hurricane and in spite of enormous political uproar this year, when the island’s residents successfully protested for the resignations of its top leaders, including ex-Governor Ricardo Rossello, who stepped down in August.

Despite all that, the president reportedly intervened to remove $6.3bn (£4.8bn) in funding from Puerto Rico in the budget before it went up for a vote and was passed by the House earlier this week.

The US territory was left with just $5.7bn (£4.4bn) in Medicaid funding in the congressional budget. The president’s reported move has meanwhile undermined Puerto Rico’s funding negotiations, as it seeks a long-term solution to the frequent funding extensions the island has been forced to request from the federal government every few years.

Mr Trump has frequently suggested Puerto Rico was corrupt — at one point referring to it as “one of the most corrupt places on Earth” — and seemingly undeserving of US aid in the wake of the catastrophic hurricane that struck the island, which was responsible for nearly 3,000 deaths in total.

News of the president’s intervention in the congressional spending bill was first reported by Politico, which cited four unidentified sources familiar with the discussions.

Chase Jennings, a spokesperson for the White House Office of Management and Budget, told the news outlet the US has faced “historical waste” in Puerto Rico and that “additional funding was not needed or fiscally responsible”.

“This administration remains committed to properly prioritising US taxpayer dollars”, the spokesperson added, describing the agreement as a “win for President Trump and the American people”.

The Puerto Rico Federal Affairs Administration, which coordinates funding negotiations between the federal government and US territory, also celebrated the passage of the spending bill in a statement that read: “We will continue to work hand-in-hand with the federal government to achieve a longer-term funding mechanism that provides stable healthcare to the people of Puerto Rico.”

But the agreement poses potentially significant issues for Puerto Rico, which, like other US territories, has its federal funding for programmes like Medicaid capped by the administration.

The island’s Medicaid programme has reportedly suffered from being underfunded over the years, and some experts say the lack of adequate health care has led to an “alarming exodus to the mainland”.

“With another funding cliff looming in two years under the new agreement, Puerto Rico may continue to lack the certainty it needs to commit to long-term increases of its very low payment rates to health care providers to stem their alarming exodus to the mainland”, Robert Greenstein, who works for the left-leaning Centre on Budget and Policy Priorities think tank, told Politico.