The TRAVEL Act, H.R. 3400, carries the full name “Territorial Response and Access to Veterans’ Essential Lifecare Act.” The act authorizes the Department of Veteran Affairs to assign physicians to travel to the U.S. territories to provide and coordinate care for veterans.
The bill was sponsored by Rep. Kimberlyn King-Hinds of the Northern Mariana Islands. The original cosponsors inbcluded Rep. Aumua Amata Radewagen of American Samoa and Rep. James Moylan of Guam. Rep. Pablo Jose Hernandez of Puerto Rico joined in as a cosponsor, as did representatives from seven different states.
After 40 minutes of debate, the bill passed 371-21.
“Hard-to-reach places”
The TRAVEL Act was praised by the House Veterans Affairs Committee chair Rep. Mike Bost, who said it would allow better medical care “in hard-to-reach places like our territories.”
King-Hinds made the same point, saying, “Too often, veterans are forced to travel thousands of miles for basic care, while the federal government fails to provide sufficient support. Our nation’s heroes deserve better. This bill is designed to ease their burden by bringing more VA physicians and specialists to our communities here in the Marianas.”
Puerto Rico is not as hard to reach as the Marianas, but there are rural areas where access is more challenging. The VA has clinics in Arecibo, Pueblo Ward, Comerio, San Juan, Guayama, Mayaguez, Utuado, and Vieques in addition to the San Juan VA Medical Center. Approximately 61,000 veterans use these facilities.
Puerto Rico
While Puerto Rico may have fewer geographic limitations than the smaller territories, there are still significant problems. A Government Office of Accountability report from 2024 pointed out that the official numbers of veterans living in the territories may not be accurate and that 51% of veterans in Puerto Rico are not eligible for reimbursement of travel costs for getting to their medical appointments. This is important because Puerto Rico, with a longstanding shortage of doctors in general and specialists in particular, cannot provide all needed services locally. Patients in Puerto Rico often must travel long distances to receive specialized care.
The report also stated that Puerto Rico has problems with delays in providing medical devices and supplies. One example given in the report: “Officials said they have had delays for up to 10 years in receiving cardiac device monitoring services and leased scopes to use for certain procedures, among other things.”
Another problem is that federally-funded payments to physicians in Puerto Rico are 25% lower than payments to doctors performing the same services in the states. This difference in revenue is one of the issues that has led to the serious shortage of doctors on the Island.
Would statehood help?
The difference in opportunities and challenges for doctors and patients in territories compared with states is evidence of the problems of territory status. While there are rural states with similar healthcare challenges, the population of Puerto Rico is similar to that of Connecticut. In fact, Puerto Rico would be #32 in size among the states if it were a state now. There is no reason for Puerto Rico to face such severe health care problems.
Puerto Rico’s healthcare funding is different from that of the states, because it is legal to treat territories differently from states. Thgis nearly always means that territories are treated worse than states. States, on the other hand, must alkl be treated equally under the U.S. Constitution.
Statehood is the solution. Reach out to your Congressional representatives and let them know that you want to see them support statehood for Puerto Rico.
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