Medicaid Improvement for Insular Areas Act of 2025

This bill ends the cap on how much federal Medicaid money U.S. territories can receive. Starting in fiscal year 2025, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are no longer limited by the old funding ceiling. The goal is to let Medicaid in these places work more like it does in the states, with funding tied to need instead of a fixed cap .

What this means in daily life: territories could have steadier support for hospitals, clinics, and patients who rely on Medicaid, especially during times of higher need, like disasters or public health emergencies. The change takes effect beginning in FY2025.

Key points

• Who is affected: Residents and health providers in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.
• What changes: The general Medicaid funding cap for territories is removed.
• When: Starting in fiscal year 2025.