Though she was an hour late to a round table event, Hillary Clinton said she had traveled to San Juan, Puerto Rico to listen to concerns about the state of healthcare in the commonwealth.
Island officials and health industry stakeholders Friday said they've spent months pressing the Obama administration to address a slew of public health issues.
Sixty percent of the island's population – over 2 million people – has care through Medicare, Medicare Advantage or Medicaid, according to The Puerto Rico Healthcare Crisis Coalition, a group of patient advocates, doctors, hospitals, insurers and business leaders.
Despite financially contributing to Social Security and Medicare taxes, Puerto Ricans enrolled in the island's Medicare Advantage program receive 60% of the average rate in the states – while also having the highest MA enrollment percentage in the U.S, according to the coalition's data.
Next year, the CMS is scheduled to cut payments to MA plans in Puerto Rico by 11%.
Medicaid doesn't fare any better.
Puerto Rico's health coverage for the poor, which is in debt to providers, has to come up with $1.8 billion by 2018 or drastically reduce the program, according to the coalition.
“If we are not helped, patients are going to suffer, and they will suffer greatly,” Jaime Plá-Cortés, president of the Puerto Rico Hospital Association, said at the round table.
All this stress on the healthcare industry has led to an exodus of providers, worsening patient access to care.
Clinton agreed that the island was being treated unfairly by Washington.
“It's hard to justify how an American citizen in Puerto Rico can be treated differently in so many ways,” Clinton said. “The way Puerto Rico is being treated when it comes to healthcare is inconsistent.”
The Democratic front runner said she would work to address the issues should she be elected, but conveyed no concrete plans on how she would do so.
Meanwhile in what was billed a showdown with Clinton, Republican candidate Marco Rubio also visited the island Friday. He gave a speech in which he blamed Clinton supporters for the U.S. territory's economic problems. He railed against giving Puerto Rico bankruptcy protection to resolve a staggering $72 billion debt.
Rubio and Clinton aren't the only two candidates courting Puerto Ricans, even though the island residents can't vote for president despite being U.S. citizens.
Jeb Bush visited Puerto Rico in April before announcing his Republican presidential campaign and was warmly received as he endorsed statehood, a long-running issue for generations of Puerto Ricans, many of whom feel like second-class citizens because of their limited voting rights.
Martin O'Malley, a Democrat and former Maryland governor who visited last month, pledged to fight for equal treatment, noting that Puerto Rico gets lower Medicaid and Medicare reimbursement rates than the mainland.
Five million Puerto Ricans live on the U.S. mainland, including nearly 1 million in the key swing state of Florida.
The Associated Press contributed to this report.