Georgetown University's Center for Children and Families will prepare a Commonwealth Fund issue brief using Puerto Rico as an example of how block-grant financing has impacted its Medicaid program and health care system capacity, and will include an analysis comparing Puerto Rico’s funding needs to annual block-grant amounts as well as assessing unanticipated Medicaid costs the territory has experienced as a result of natural disasters and past economic declines as context on whether Healthy Adult Opportunity provisions would provide sufficient protections for states.