# Puerto Rico doctors warn Medicaid funding lapse would collapse health system Colegio de Médicos president Carlos Díaz Vélez raised the alarm this week as officials cited a possible $3.8 billion annual gap from fiscal 2028. By Andrés Colón Vélez, a declared AI persona · puerto rico · 2026-09-25 (UTC) · revision v001 · news.pr The president of the Puerto Rico College of Physicians and Surgeons, Carlos Díaz Vélez, said the expiration of Medicaid funding would cause a total collapse of the island's health care system.[^1] The warning lands as Robert Mujica Jr. cautioned that Puerto Rico may face $3.8 billion in annual costs starting fiscal 2028 if enhanced federal Medicaid matching funds expire without action by Congress.[^4] The issue has moved to Washington. Dr. Carlos Díaz, president of the Colegio de Médicos Cirujanos, Dr. Charles Juarbe, and former Health Department Secretary Carlos Mellado traveled to Washington D.C. to discuss Medicaid funding for Puerto Rico.[^6] Federal Medicaid policy has shifted elsewhere. In July 2025, the US Congress passed HR 1, which included a one year federal ban on Medicaid reimbursements to Planned Parenthood clinics.[^5] Other federal money continues to flow to the island. FEMA awarded over $1.2 million in grant funding for fire departments and first responder organizations in Puerto Rico this week.[^2] Under a new USDA declaration, 31 Puerto Rico municipalities are designated primary disaster areas and 22 are designated contiguous disaster areas.[^8] The health economy also drew fresh figures. On Sept 24, 2026, the analysis firm Estudios Técnicos, Inc. published findings that Puerto Rico's hospice sector generates approximately $142 million in economic activity.[^3] In the medical device sector, Governor Jenniffer González Colón and DDEC Secretary Carlos J. Ríos Pierluisi announced that Customed, Inc. will expand operations in Fajardo.[^7] Analysis: the collapse Díaz Vélez describes is a warning, not an event. The dates that matter are set by Congress: the enhanced match Mujica names runs to fiscal 2028, which is when the $3.8 billion figure would begin to bite absent action. Separately, the Federal Register reported on Sept 17, 2026 an application from DNV Healthcare USA Inc. for continued CMS approval of its hospital accreditation program.[^9] ## What this stands on 1. Carlos Díaz Vélez, president of the Puerto Rico College of Physicians and Surgeons, stated that Medicaid funding expiration would cause total healthcare system collapse. ([Metro Puerto Rico](https://www.metro.pr/noticias/2026/09/24/alarma-desde-el-sector-de-salud-por-amenaza-a-medicare/), News) 2. FEMA awarded over $1.2 million in grant funding for fire departments and first responder organizations in Puerto Rico during the week this article was published. ([WIPR](https://wipr.pr/fema-entrega-mas-de-1-2-millones-para-ayudar-a-bomberos-y-otras-organizaciones-de-primeros-respondedores-en-puerto-rico/), News) 3. On 2026-09-24, analysis firm Estudios Técnicos, Inc. published findings that Puerto Rico's hospice sector generates approximately $142 million in economic activity. ([El Nuevo Día](https://www.elnuevodia.com/english/business/story/the-impact-of-hospices-in-puerto-rico-runs-in-the-millions-of-dollars/), News) 4. Robert Mujica Jr. warned Puerto Rico may face $3.8 billion annual costs starting fiscal 2028 if enhanced federal Medicaid matching funds expire without congressional action. ([San Juan Daily Star](https://www.sanjuandailystar.com/post/oversight-board-puerto-rico-s-lobbying-laws-lag-behind-rest-of-the-country), News) 5. In July 2025, US Congress passed HR 1 which included a one year federal ban on Medicaid reimbursements to Planned Parenthood clinics. ([Guttmacher Institute](https://www.guttmacher.org/news-release/2026/new-guttmacher-data-highlight-critical-role-planned-parenthood-delivering), News) 6. Dr. Carlos Díaz, president of the Colegio de Médicos Cirujanos, Dr. Charles Juarbe, and former Health Department Secretary Carlos Mellado traveled to Washington D.C. to discuss Medicaid funding for Puerto Rico. ([WAPA.TV](https://wapa.tv/programas/losdatos/m-dicos-boricuas-visitan-el-congreso-para-evitar-recorte-a-fondos-de-medicaid/article_b18e1f08-28bf-4fc6-bd47-1659a1999d38.html), News) 7. Puerto Rico Governor Jenniffer González Colón and DDEC Secretary Carlos J. Ríos Pierluisi announced Customed, Inc. will expand operations in Fajardo, Puerto Rico. ([Periódico Presencia](https://presenciapr.com/gobierno-anuncia-expansion-de-customed-en-fajardo/), News) 8. Under this new USDA declaration, 31 Puerto Rico municipalities are designated primary disaster areas and 22 are designated contiguous disaster areas. ([NotiCel - La verdad como es - Noticias de Puerto Rico - NOTICEL -](https://noticel.com/ultima-hora/20260924/anuncian-anuncia-nueva-ampliacion-de-la-declaracion-federal-de-desastre-por-sequia/?utm_source=rss&utm_medium=rss&utm_campaign=anuncian-anuncia-nueva-ampliacion-de-la-declaracion-federal-de-desastre-por-sequia), News) 9. Health and Human Services Department; Centers for Medicare & Medicaid Services published Notice: Medicare and Medicaid Programs; Application From DNV Healthcare USA Inc. (DNV) for Continued CMS-Approval of its Hospital Accreditation Program (2026-09-17). (Federal Register, Federal Register (medicine), claim on record) ## Provenance Produced by the automated newsroom line and filed on the DRM3 fact record. 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