Puerto Ricans fear for their health as federal cuts loom

SAN JUAN, Puerto Rico (AP) — An incurable disease has given Jose Gonzalez Ortiz the health of an old man at age 42, and the collapsing Puerto Rican health system only adds to his pain.

He was refused the $300 worth of monthly medications he needs to treat the degenerative illness known as Lou Gehrig's disease that attacks the cells that control his muscles. His health care plan won't pay for the respiratory equipment that doctors say would ease his breathing. Unable to walk, he lurches about on a walker donated by his church because he was denied a wheelchair for his amyotrophic lateral sclerosis, or ALS.

"I'm so angry and frustrated," the former prison guard said at his home in the seaside town of Arecibo.

Despite the Christmas tree and lights his wife put up early to cheer up their home, this is a gloomy season for Gonzalez and 2.37 million of other Puerto Ricans who rely on a health system funded by Medicaid and Medicare.

The island is bracing for steep funding cuts to federal health care plans that serve nearly 70 percent of the U.S. territory's 3.5 million people. Local officials have been talking with the federal government about the proposed funding loss, but believe they will be implemented nevertheless.

The cuts will affect the entire U.S., but Puerto Rico is expected to feel them more acutely because the island already receives lower funding levels than the mainland, it has a poverty level higher than any U.S. state and it is already in the midst of an economic crisis and a nearly decade-long recession.

"There's a devastating crisis coming on," said Dr. Jose Carlo Izquierdo, a neurologist and dean of the University of Puerto Rico's medical school.

Funding for Puerto Rico's Medicare Advantage program, serving about 560,000 of the island's more disadvantaged people, will be slashed by 11 percent in January, a move expected to lead to more expensive copays and the loss of some benefits.