Why does Puerto Rico's healthcare system face constant funding shortfalls despite serving U.S. citizens? In this episode of the Mano a Mano podcast, host George Laws Garcia sits down with healthcare policy expert Luis E. Pizarro Otero, Esq., to unpack the structural inequalities that have created a healthcare crisis in Puerto Rico.

Luis, who has spent over 15 years advocating for Puerto Rico healthcare policy in Washington, D.C., shares his firsthand experience witnessing how territorial status creates a two-tiered system where Puerto Ricans receive less federal Medicaid and Medicare support than any U.S. state. We explore how the Affordable Care Act improved but didn't fully solve Puerto Rico's healthcare funding gap, why hospitals are closing across the island, and how this drives medical migration to the mainland.

This conversation reveals the real-world consequences of Puerto Rico's unequal treatment under federal programs—from the Medicaid cliff and Medicare payment disparities to the pharmaceutical manufacturing sector that supplies 50% of America's top medications while facing its own healthcare shortages. The episode sheds light on how achieving statehood would fundamentally transform Puerto Rico's healthcare landscape by guaranteeing equal federal funding formulas and ending the cycle of temporary funding patches.

In this episode:

• How Puerto Rico's Medicaid funding compares to states (55% vs. 83% federal match)
• The Affordable Care Act's temporary fix and the ongoing funding cliff
• Why Puerto Rico hospitals are closing despite serving U.S. citizens
• Medicare Advantage disparities and healthcare provider challenges
• How territorial status affects pharmaceutical manufacturing in Puerto Rico
• The medical migration crisis: providers and patients fleeing to the mainland
• Private insurance challenges and workforce healthcare access
• Why statehood would end healthcare inequality through permanent federal parity

Timestamps:

00:00 Introduction: Luis Pizarro's Healthcare Advocacy Journey

03:45 The Medicaid Funding Gap: 55% vs. 83% Federal Match

07:30 How the Affordable Care Act Changed Puerto Rico Healthcare

12:45 The Medicaid Cliff and Temporary Funding Patches

18:20 Hospital Closures and Healthcare System Contraction

23:30 Medicare Payment Disparities for Puerto Rico Providers

28:15 Pharmaceutical Manufacturing: Puerto Rico's Critical Role

33:40 The Medical Migration Crisis: Providers Leaving for Mainland

38:50 Healthcare Workforce Shortages and Economic Impact

44:20 Congressional Attitudes: From Low IQ to Growing Understanding

48:30 Private Health Insurance Challenges in Puerto Rico

53:00 The Private Patient Paradox: Last in Line for Care

56:30 Why Statehood Provides the Permanent Healthcare Solution

🔔 Subscribe for weekly deep dives into how Puerto Rico's territorial status affects real policy issues.

Guest Bio: Luis E. Pizarro Otero, Esq., is a healthcare policy expert who has advocated for Puerto Rico healthcare equity in Washington, D.C. for over 15 years. He previously served as President of the Puerto Rico Chamber of Commerce and has worked extensively with the Puerto Rico Medicaid and Medicare Advantage Products Association (MMAPA) on federal healthcare policy.

#PuertoRico #Healthcare #Medicaid #Medicare #LuisPizarro #ManoAManoPodcast #PuertoRicoStatehood #HealthcareInequality #AffordableCareAct #HospitalClosures #MedicalMigration #TerritorialStatus #HealthcarePolicy #FederalEquity

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.

As the federal government faces another potential shutdown, what does this mean for Puerto Rico's 14,000 federal employees and essential services? In this episode of the Mano a Mano podcast, hosts George Laws Garcia and Martin Rivera analyze the ongoing federal government funding fight, escalating military tensions with Venezuela, updates on the island’s Financial Oversight & Management Board (FOMB), and the unprecedented economic impact of Bad Bunny's record-breaking residency.

They discuss President Trump's controversial dismissal of Puerto Rico's FOMB members and the resulting legal challenges, the strategic military buildup on the island in response to Venezuelan narco-trafficking operations, and how Bad Bunny's 30-show residency generated over $713 million for Puerto Rico's economy while sparking fresh debate about the island's political status.

In this episode:

• Government shutdown deadline: What's at stake for Puerto Rico's federal workers?
• U.S. military strikes off Venezuela's coast and Puerto Rico's strategic role
• Military buildup in Puerto Rico: Roosevelt Roads and Ramey Air Force Base reactivation
• Island public opinion polls showing 70-88% support for U.S. military presence
• President Trump fires six of seven FOMB members
• Legal challenges to FOMB member dismissals and constitutional questions
• Bad Bunny's residency: 600,000 attendees and $713 million economic impact
• Political status debate: Artist advocacy vs. voter preferences

Timestamps:

00:00 Introduction & Episode Overview

00:38 Government Funding Crisis: Seven Days to Shutdown

02:30 House and Senate Proposals: What's the Difference?

03:30 U.S. Military Action Against Venezuelan Drug Boats

05:00 Puerto Rico's Strategic Value in Caribbean Security

06:15 Military Buildup: Pre-Positioning Assets on the Island

07:05 Island Leadership Response to Military Presence

08:20 Public Polling: Strong Support for Military Facilities

09:35 National Security Importance of Puerto Rico

10:20 Financial Oversight & Management Board Crisis Explained

12:02 Presidential Appointment Process Under PROMESA

12:35 Legal Challenges by Fired Board Members

14:10 Impact on Energy Grid Restructuring and PREPA Debt

15:00 First Balanced Budget Achievement

15:45 Bad Bunny Residency: Record-Breaking Economic Impact

16:40 Tourism Statistics and Global Reach

18:16 Bad Bunny's Political Stance on Statehood

19:30 Democracy Through the Ballot Box vs. Celebrity Opinion

20:10 Conclusion & Call to Action

🔔 Subscribe for weekly analysis of Puerto Rico's political, economic, and cultural developments.

#PuertoRico #GovernmentShutdown #Venezuela #MilitarySecurity #FOMB # LaJunta #BadBunny #PuertoRicoEconomy #ManoAManoPodcast #PuertoRicoStatehood #Tourism #NationalSecurity #CaribbeanSecurity

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.

Has Puerto Rico been trapped in a colonial status under the guise of  local "autonomy"? Why is Puerto Rico still called a "Commonwealth" when it's actually a U.S. territory under colonial rule? In this episode of the Mano a Mano podcast, host George Laws Garcia sits down with Columbia Law Professor Christina Ponsa-Kraus to explore both the constitutional reality of Puerto Rico's status and the fascinating history of Puerto Rican autonomism that today's politicians have completely misrepresented.

Professor Ponsa-Kraus, who helped draft the Puerto Rico Status Act that passed the House in 2022, reveals how self-proclaimed "autonomist" politicians like Resident Commissioner Pablo José Hernández have misinterpreted 19th-century ideology end ended up promoting the exact opposite of what the original autonomists wanted. We explore how some of the autonomist leaders - like Federico Degetau González and José Celso Barbosa - actually embraced American statehood as the fulfillment of their goals for genuine self-government, not as a threat to Puerto Rican identity.

This deep-dive conversation exposes how "Commonwealth" is essentially a misleading label for what is legally a territory subject to Congress's absolute plenary power, while tracing the historical roots of autonomism back to Spanish colonial rule and revealing why early autonomists saw American federalism as "maximum decentralization within national unity." We weave history, constitutional law, and current politics to highlight a compelling vision of how Puerto Rico and the U.S. can exit the trap of territorial colonialism, and open a new chapter of our relationship based on mutual respect, self-determination and shared democratic values.  

In this episode:

• The true history of Puerto Rican autonomism and why many of its leaders originally supported statehood
• Why Puerto Rico's "Commonwealth" status is still territorial colonialism under constitutional law
• How today's "autonomist" politicians have misappropriated historical terminology
• The difference between real autonomy (statehood/independence) and fake autonomy (commonwealth)
• How Congress's plenary power keeps Puerto Rico subordinate and powerless
• Why the Puerto Rico Status Act excluded the current territory status from decolonization options
• The recent firing of Fiscal Oversight Board members and what it reveals about democratic deficits
• How statehood would actually protect Puerto Rican culture through political empowerment

Timestamps: 00:00 Introduction & Christina's Constitutional Law Expertise 06:30 Why Puerto Rico is Missing from American Education 12:45 The Puerto Rico Status Act & Congressional Collaboration Process 22:15 What is Puerto Rico's "Commonwealth" Status Really? 31:20 Why Commonwealth Was Excluded from Decolonization Options 40:19 The Real History of 19th Century Puerto Rican Autonomism 44:08 How Historical Autonomists Embraced American Statehood 48:20 Modern "Autonomism" vs. Historical Autonomist Goals 52:30 The Fiscal Oversight Board Crisis & Democratic Deficits 56:37 Why Statehood Provides Better Autonomy Than "Commonwealth" 01:03:24 Cultural Preservation Through Political Empowerment 01:08:45 Debunking the "Loss of Culture" Myth 01:10:29 Recommendations for Advancing Puerto Rico Statehood

🔔 Subscribe for more deep dives into Puerto Rico's true history and path to equality.

👉 Read Prof. Christina Ponsa-Kraus’s chapter, “When Statehood Was Autonomy,” in Reconsidering the Insular Cases(Harvard University Press / Harvard Law School Human Rights Program).

Read the chapter here: https://www.law.columbia.edu/sites/default/files/2020-09/When%20Statehood%20Was%20Autonomy_0.pdf

#PuertoRico #Autonomism #PuertoRicoStatehood #ChristinaPonsaKraus #ManoaManoPodcast #PuertoRicanHistory #Decolonization #Commonwealth #ConstitutionalLaw #PabloJoseHernandez #Colony #Territory #PlenaryPower

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.

Why is Puerto Rico's energy system still struggling 7 years after Hurricane Maria, and how does territorial status make everything worse? In this episode of the Mano a Mano podcast, host George Laws Garcia sits down with Tom King, founder of the Borincana Foundation and Puerto Rico Energy Forum, to break down the island's complex energy crisis.

They explore the ongoing PREPA debt bankruptcy that's blocking billions in federal recovery funds, the reality behind Puerto Rico's energy privatization efforts, and why distributed solar has become both a solution and new challenge for the grid. Tom shares expert insights on fossil fuels and renewables are not mutually exclusive but are both needed to complement each other as Puerto Rico advances its energy transformation process, the recent Sunnova bankruptcy affecting thousands of Puerto Rican solar customers, and how property title issues still limit energy financing.

Most importantly, they discuss why Puerto Rico's territorial status creates systemic barriers to reliable energy and economic development - from limited access to capital markets to population decline that reduces the customer base needed to support grid investments.

In this episode:

• Why PREPA's debt crisis is blocking $12-19 billion in federal reconstruction funds
• The truth about Puerto Rico's energy "privatization"
• How 115,000 homes got solar despite grid challenges
• Why Sunnova's bankruptcy is challenging Puerto Rico's solar boom
• Property title problems blocking energy financing
• How territorial status infantilizes Puerto Rico's development
• Why statehood would help solve systemic energy investment barriers

Timestamps:

00:00 Introduction and Guest Introduction

01:40 Tom King's Background and Involvement in Puerto Rico's Energy Sector

05:22 Current State of Puerto Rico's Energy System

06:49 Challenges and Controversies in Energy Privatization

10:38 Financial and Infrastructure Hurdles

15:05 Debate on Fuel Sources and Renewable Energy

23:07 Impact of Renewable Energy on the Grid

28:39 Population Decline and Political Status

30:49 Challenges of Puerto Rico's Energy System

31:16 The Impact of Puerto Rico's Territorial Status

32:02 Energy Costs and Stability in Puerto Rico

35:12 Property Title Issues and Economic Impact

38:24 Sunnova's Bankruptcy and Its Implications

44:54 Future of Puerto Rico's Energy Sector

53:37 Resources and Initiatives for Energy Development

🔔 Subscribe for weekly deep-dives into Puerto Rico's path to decolonization and statehood.

#PuertoRico #EnergyPolicy #PuertoRicoStatehood #Decolonization #PREPA #LUMAEnergy #SolarPower #TerritoryStatus #ManoAManoPodcast #PuertoRicoGrid

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.

How does Puerto Rico's territorial status affect hurricane preparedness, military service, and Congressional representation during critical national moments? In this episode of the Mano a Mano podcast, hosts George Laws Garcia and Martin Rivera examine the 2025 hurricane season preparations, recent U.S. airstrikes in Iran, and what these events reveal about Puerto Rico's unequal status.

They discuss the ongoing Congressional budget reconciliation process, threats to Puerto Rico's Opportunity Zone designations, and how territorial inequality impacts disaster response and military representation. The hosts also cover the UN Committee on Decolonization hearings and analyze the surprising NYC mayoral primary results that highlight Puerto Rican voting power stateside.

In this episode:

• 2025 hurricane season predictions and Puerto Rico's preparedness challenges
• How territorial status affects disaster response and federal representation
• U.S. airstrikes in Iran and Puerto Rican military service without voting rights
• Congressional budget reconciliation updates affecting Puerto Rico
• Opportunity Zones under threat in tax legislation
• UN Decolonization Committee: Annual theater or meaningful action?
• NYC mayoral primary upset and Puerto Rican voter influence
• AOC's endorsement strategy and implications for statehood advocacy

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.

Why does Congress’s budget reconciliation bill matter for Puerto Rico’s health, economy and push for statehood? In this episode of the Mano a Mano Podcast, hosts George Laws Garcia and Martín Rivera of the Puerto Rico Statehood Council  unpack how the 2025 reconciliation package could reshape Medicaid and nutritional assistance and other federal funding amid the expected nationwide federal funding cuts. They also discuss proposed tax incentives to increase local manufacturing, recent remarks from Puerto Rico’s Governor and Resident Commissioner on territorial status, Congressman Pablo José Hernández’s reluctance to recognize island voters’ desire for  statehood (and his party-refounding plans), the truth about the Jones Act’s impact on shipping costs and food security, and why the Trump Administration might want to speak up about Puerto Rico’s path to statehood.

In this episode:

• What healthcare and nutrition funding changes are on the table?
• Which tax incentives could attract new manufacturers?
• Why are Puerto Rico’s top elected leaders saying about political status?
• What is the debate on the Jones Act’s impact on Puerto Rico?

Timestamps:

00:00 Introduction & Episode Overview

00:45 Budget Reconciliation Basics for Puerto Rico

04:10 Impact on Healthcare & Nutrition Programs

07:50 Tax Incentives & Manufacturing Proposals

12:15 Political Status Debate: Governor & Resident Commissioner

16:30 Congressman Hernández & Party Refoundation

23:53 Mailbag: Listener Questions Answered

24:19 What is the Jones Act’s impact on Puerto Rico?

30:03 Trump Administration’s Statehood Signals

28:50 Personal Reflections & Next Steps

🔔 Subscribe for weekly deep-dives into Puerto Rico’s political and economic landscape.

#PuertoRico #BudgetReconciliation #JonesAct #HealthcareReform #Statehood #ManoAManoPodcast

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.

Why are Puerto Rico’s tax laws so misunderstood? In this episode of the Mano a Mano podcast, host George is joined by Simón Carlo Valentín - tax attorney and CPA - to break down the complexities of Puerto Rico’s tax system.

They explore the truth about federal taxes in Puerto Rico, the impact of recent U.S. and local tax reforms, and how these policies shape the island’s economy and its push for statehood. Simon shares expert insights on tariffs, tax code misconceptions, and what fiscal policy changes may be needed for Puerto Rico to fully integrate with the United States.

In this episode:

• Do Puerto Ricans pay federal taxes?
• How U.S. tariffs affect the island
• Local tax reform and economic development
• Myths vs. facts on Puerto Rico’s tax system
• Tax implications of Puerto Rico statehood

Timestamps:

06:49 Federal Payroll Taxes and Inequities

10:23 Puerto Rico's Contributions to Federal Taxes

16:17 Impact of Tariffs on Puerto Rico

20:55 Federal Tax Policy and Manufacturing Incentives

25:05 Impact of Hurricane Maria on US Medical Supply Chain

25:30 Proposed Manufacturing Redundancy Plan for National Security

27:06 Economic Incentives and Tax Policies in Puerto Rico

28:16 Disparities in Compensation and Intellectual Property Issues

34:52 Local Tax Reform Efforts in Puerto Rico

40:17 Act 60 and Its Implications for Statehood

44:15 Vision for Puerto Rico's Statehood and Federal Tax Integration

47:02 Community Engagement and Political Advocacy

49:36 Conclusion and Call to Action

🔔 Subscribe for more deep dives into Puerto Rico’s political and economic future.

#PuertoRico #Taxes #PuertoRicoStatehood #SimonCarloValentin #TaxPolicy #ManoaManoPodcast #PuertoRicoEconomy #FederalTaxes

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.

In this episode,  George and Martín discuss the celebration of Florida’s Puerto Rico Day at the Capitol, emphasizing bipartisan support for Puerto Rican issues within the Florida House of Representatives. They also talk about their advocacy efforts in Washington D.C. to advance Puerto Rico's statehood status at the recent Puerto Rico Equality and Statehood Summit.

The conversation highlights the contrasting views within Puerto Rican political figures on the island's status issue, notably focusing on the actions of resident commissioner Pablo José Hernandez. In addition, the episode touches on rumors about the Trump administration considering an executive order to impose independence on Puerto Rico and debunks misinformation around it. 

The discussion also honors the memories of Raul Grijalva, former chairman of the House Natural Resources Committee, and Lincoln Diaz-Balart, former U.S. Representative, recognizing their contributions to Puerto Rican statehood and equality. Join us to understand the political dynamics and ongoing efforts to resolve Puerto Rico's status.

00:00 Introduction and Opening Remarks

02:42 Celebrating Puerto Rican Advocacy

07:06 Bipartisan Support in Florida

09:40 Controversies and Challenges

14:35 Rumors and Misinformation

22:21 Honoring Champions of Equality

30:24 Conclusion and Call to Action

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.

In this episode of the Mano a Mano podcast, George Laws Garcia and Martin Rivera discuss a recent visit to Puerto Rico for the Right to Democracy Summit on U.S. Colonialism, where a cross-territorial coalition worked towards ending the unjust treatment of U.S. citizens and U.S. nationals in all of America's territories. Their discussion also highlights the upcoming Puerto Rico Equality and Statehood Summit in Washington D.C. hosted by the Government of Puerto Rico, and how citizen advocates are shaping the future of the movement to end the injustices of territorial colonialism and advance full equality and democracy through statehood. The episode wraps up with answers to listeners' questions about issues ranging from sovereignty to gentrification in Puerto Rico.

Tune in for an in-depth analysis of cultural, political, and social factors affecting the Puerto Rico’s statehood movement.

00:45 Recent Visit to Puerto Rico and Cross Territorial Coalition

02:11 Cultural Differences and Common Goals

05:43 Territorial Status and Self-Determination

16:15 Upcoming Puerto Rico Equality and Statehood Summit

21:32 Mailbag: Answering Audience Questions

29:26 Conclusion and Call to Action

Watch episodes of Mano a Mano on YouTube @PuertoRico51st.

Interested in learning more about the statehood movement? 
Visit our Website: https://www.pr51st.com
Sign-up for Email Updates: http://www.pr51st.com/take-action/sign-up/

Follow us on: 
Facebook - @PR51st
Twitter - @PuertoRico51st
Instagram - @PR51st

Produced by Caandor Labs.