此外，即使岛上的医生相比美国大陆需要补贴的费率更低（波多黎各政府必须承担大部分的成本 ) ， 波多黎各处于可承受医疗法案的覆盖之下并必须支付相应的费用，其他福利也是如此。
Moreover, Puerto Rico is covered by the Patient Protection and Affordable Care Act and must pay accordingly, even though the island’s doctors are compensated at a lower rate than those on the mainland (and the Puerto Rican government must bear much of the cost). The same is true of some other welfare payments.