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

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.

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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.

Shape Created with Sketch. Bringing aid to Puerto Rico Show all 20 left Created with Sketch. right Created with Sketch. Shape Created with Sketch. Bringing aid to Puerto Rico 1/20 Crew chief Kenney shelters under the blade of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit preparing to take off during recovery efforts following Hurricane Maria, in Isla Grande, Puerto Rico, October 6, 2017 Reuters/Lucas Jackson 2/20 An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit takes off behind Crew Chief Alexander Blake and his fellow soldiers during recovery efforts following Hurricane Maria, in Morovis, October 5, 2017 Reuters/Lucas Jackson 3/20 Crew member Bynum stands in tropical rain as a HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit prepares to take off during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017 Reuters/Lucas Jackson 4/20 UH-60 Blackhawk helicopter pilot Chris Greenway receives a hug from a woman thanking him for water as he works with the First Armored Division's Combat Aviation Brigade during recovery efforts following Hurricane Maria, in Verde de Comerio, October 7, 2017 Reuters/Lucas Jackson 5/20 A man carries a case of water away from an HH-60 Blackhawk helicopter after soldiers working with 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017 Reuters/Lucas Jackson 6/20 Crew chief Alexander Blake from 101st Airborne Division's "Dustoff" unit loads water into a helicopter during recovery efforts following Hurricane Maria, in Isla Grande, October 5, 2017 Reuters/Lucas Jackson 7/20 Residents wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo Reuters 8/20 An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field to avoid lightning during recovery efforts following Hurricane Maria, in Manati, October 5, 2017 Reuters/Lucas Jackson 9/20 Residents hold their hands aloft to signal that they need water as UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade fly past during recovery efforts following Hurricane Maria, near Ciales, October 7, 2017 Reuters/Lucas Jackson 10/20 Tropical rain splashes on a runway as HH-60 Blackhawk helicopters from 101st Airborne Division's "Dustoff" unit wait for weather to clear during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017 Reuters/Lucas Jackson 11/20 Pilot Eldwin Bocanegra Torres speaks with residents isolated by landslides in the mountains after unloading water and food from a helicopter during recovery efforts following Hurricane Maria, near Utuado, October 10, 2017 Reuters/Lucas Jackson 12/20 Residents stand in front of wind-damaged trees as they wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017 Reuters/Lucas Jackson 13/20 The contents of a home are seen from the air during recovery efforts following Hurricane Maria near Utuado, October 10, 2017 Reuters/Lucas Jackson 14/20 Thomas looks out of the window of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit, loaded with relief supplies, during recovery efforts following Hurricane Maria in Isla Grande, October 6, 2017 Reuters/Lucas Jackson 15/20 A message written on the rooftop is seen from the air during recovery efforts following Hurricane Maria near Humacao, October 10, 2017 Reuters/Lucas Jackson 16/20 A HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field during recovery efforts following Hurricane Maria in San Sebastian, October 6, 2017 Reuters/Lucas Jackson 17/20 Sergeant First Class Eladio Tirado, who is from Puerto Rico, looks for a landing spot for a UH-60 Blackhawk helicopter from the First Armored Division's Combat Aviation Brigade, during recovery efforts following Hurricane Maria near Ciales, October 7, 2017 Reuters/Lucas Jackson 18/20 Boys carry water away from an HH-60 Blackhawk helicopter after soldiers working with the U.S. Army's 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017 Reuters/Lucas Jackson 19/20 Sergeant First Class Eladio Tirado from the First Armored Division's Combat Aviation Brigade, who is from Puerto Rico, speaks with residents as he helps during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017 Reuters/Lucas Jackson 20/20 Residents peek through a fence at helicopters from 101st Airborne Division's "Dustoff" unit that had parked in a locked field during recovery efforts following Hurricane Maria, in Lares, October 6, 2017 Reuters/Lucas Jackson 1/20 Crew chief Kenney shelters under the blade of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit preparing to take off during recovery efforts following Hurricane Maria, in Isla Grande, Puerto Rico, October 6, 2017 Reuters/Lucas Jackson 2/20 An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit takes off behind Crew Chief Alexander Blake and his fellow soldiers during recovery efforts following Hurricane Maria, in Morovis, October 5, 2017 Reuters/Lucas Jackson 3/20 Crew member Bynum stands in tropical rain as a HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit prepares to take off during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017 Reuters/Lucas Jackson 4/20 UH-60 Blackhawk helicopter pilot Chris Greenway receives a hug from a woman thanking him for water as he works with the First Armored Division's Combat Aviation Brigade during recovery efforts following Hurricane Maria, in Verde de Comerio, October 7, 2017 Reuters/Lucas Jackson 5/20 A man carries a case of water away from an HH-60 Blackhawk helicopter after soldiers working with 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017 Reuters/Lucas Jackson 6/20 Crew chief Alexander Blake from 101st Airborne Division's "Dustoff" unit loads water into a helicopter during recovery efforts following Hurricane Maria, in Isla Grande, October 5, 2017 Reuters/Lucas Jackson 7/20 Residents wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo Reuters 8/20 An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field to avoid lightning during recovery efforts following Hurricane Maria, in Manati, October 5, 2017 Reuters/Lucas Jackson 9/20 Residents hold their hands aloft to signal that they need water as UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade fly past during recovery efforts following Hurricane Maria, near Ciales, October 7, 2017 Reuters/Lucas Jackson 10/20 Tropical rain splashes on a runway as HH-60 Blackhawk helicopters from 101st Airborne Division's "Dustoff" unit wait for weather to clear during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017 Reuters/Lucas Jackson 11/20 Pilot Eldwin Bocanegra Torres speaks with residents isolated by landslides in the mountains after unloading water and food from a helicopter during recovery efforts following Hurricane Maria, near Utuado, October 10, 2017 Reuters/Lucas Jackson 12/20 Residents stand in front of wind-damaged trees as they wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017 Reuters/Lucas Jackson 13/20 The contents of a home are seen from the air during recovery efforts following Hurricane Maria near Utuado, October 10, 2017 Reuters/Lucas Jackson 14/20 Thomas looks out of the window of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit, loaded with relief supplies, during recovery efforts following Hurricane Maria in Isla Grande, October 6, 2017 Reuters/Lucas Jackson 15/20 A message written on the rooftop is seen from the air during recovery efforts following Hurricane Maria near Humacao, October 10, 2017 Reuters/Lucas Jackson 16/20 A HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field during recovery efforts following Hurricane Maria in San Sebastian, October 6, 2017 Reuters/Lucas Jackson 17/20 Sergeant First Class Eladio Tirado, who is from Puerto Rico, looks for a landing spot for a UH-60 Blackhawk helicopter from the First Armored Division's Combat Aviation Brigade, during recovery efforts following Hurricane Maria near Ciales, October 7, 2017 Reuters/Lucas Jackson 18/20 Boys carry water away from an HH-60 Blackhawk helicopter after soldiers working with the U.S. Army's 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017 Reuters/Lucas Jackson 19/20 Sergeant First Class Eladio Tirado from the First Armored Division's Combat Aviation Brigade, who is from Puerto Rico, speaks with residents as he helps during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017 Reuters/Lucas Jackson 20/20 Residents peek through a fence at helicopters from 101st Airborne Division's "Dustoff" unit that had parked in a locked field during recovery efforts following Hurricane Maria, in Lares, October 6, 2017 Reuters/Lucas Jackson

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.