Why it Matters

More than 3.5 million Americans living in U.S. territories, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands, face a compounding set of federal funding pressures that could reshape access to health care, education, and housing. The U.S. territories hearing in June 2026, scheduled before the Senate Energy and Natural Resources Committee on Wednesday, June 17, arrives as Congress has passed Medicaid cuts set to take effect in October and the White House has proposed slashing non-defense discretionary spending by approximately 23%, or $163 billion.

The Big Picture

The reconciliation law, H.R. 1, includes Medicaid cuts that, starting October 1, 2026, will cause many lawfully present immigrants to lose Medicaid or CHIP eligibility, regardless of how long they have been in the United States. That provision lands particularly hard on territories that already receive far less federal Medicaid support than states. In fiscal year 2019, federal base block grants financed only 13.9% of total Medicaid spending in Puerto Rico, 15.5% in Guam, 11.1% in the Commonwealth of the Northern Mariana Islands, 12.1% in the U.S. Virgin Islands, and 22.2% in American Samoa.

President Trump's FY2026 budget proposed eliminating the Low Income Home Energy Assistance Program and cutting non-defense discretionary spending broadly. As of October 2025, frozen education dollars, looming Medicaid cuts, and slashed housing funds were already reported to be threatening essential services across the territories. The Financial Oversight and Management Board for Puerto Rico has separately warned that Puerto Rico's economy has been propped up by non-recurring federal funds and encouraged the territorial government to plan for the end of those funds.

A Congressional Research Service report, updated on January 30, 2026, found that U.S. territories are dramatically underrepresented in federal statistical data. Of 449 federal statistical products, Puerto Rico appeared in only 81, the U.S. Virgin Islands in 49, Guam in 45, and both American Samoa and the Commonwealth of the Northern Mariana Islands in only 41. The Center on Budget and Policy Priorities has documented that federal policies systematically exclude territories from full participation in federal health and economic security programs.

The Bottom Line

Residents of U.S. territories cannot vote in federal elections and have no voting representation in Congress, meaning the June 17, hearing before the committee chaired by Sen. Mike Lee (R-UT) is one of the few formal venues where territory-specific concerns reach the Senate floor. Sen. Martin Heinrich (D-NM) serves as Ranking Member. The congressional hearing on territories is set at 366 Dirksen Senate Office Building, with the committee's 20 members drawn from both parties.

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