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PS 956

Para enmendar la Sección 3 del Artículo VI de la Ley Núm. 72 de 7 de septiembre de 1993, según enmendada, conocida como “Ley de la Administración de Seguros de Salud de Puerto Rico”, añadiendo un nuevo inciso (m) que incluya en el plan de salud “Vital” a los menores de 21 años con discapacidades cognitivas, físicas, fisiológicas o complejas, y extienda la cobertura de servicios de salud en el hogar a esta población; y para otros fines relacionados.

2025-2028 Session

Expands Puerto Rico's Vital health plan to cover minors under 21 with disabilities and extends in-home health services to this population.

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Bill Summary · PS 956

Legislative bill overview

Bill PS 956 proposes amending Puerto Rico's Health Insurance Administration Law to expand the "Vital" health plan to include minors under 21 years old with cognitive, physical, physiological, or complex disabilities. The bill specifically extends home health services coverage to this population, addressing a gap in current health insurance provisions for disabled youth.

Why is this important

Approximately 40,000+ minors with disabilities in Puerto Rico could gain access to subsidized health insurance and in-home care services, reducing financial barriers to essential health services for families with disabled children. This expansion addresses critical gaps in the current system where disabled youth aged 18-21 may lose coverage or face limited home care options, potentially improving health outcomes and reducing emergency room utilization among this vulnerable population.

Potential points of contention

  • Fiscal impact: Expanding Vital coverage to include home health services for an additional population segment requires budget allocation; the bill does not specify funding mechanisms or estimated costs
  • Definition clarity: Terms like "complex disabilities" lack precise clinical definition, potentially creating disputes about eligibility and coverage scope
  • Service delivery capacity: Puerto Rico's home health care infrastructure may face capacity constraints adding thousands of new patients, potentially affecting service quality and wait times
  • Age cutoff rationale: The 21-year cutoff may create coverage gaps for disabled individuals aging out, potentially shifting costs to other systems or leaving young adults uninsured

Compiled from official sources — confirm details with the bill’s official record.

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