Nearly three weeks after Hurricane Maria landed in Puerto Rico as a Category 4 hurricane, health care providers are still struggling. Almost all of the community health centers — which are a lifeline for the poorest people — on the western half of the island were still closed Friday or operating at partial capacity.

Puerto Rico is more reliant on its safety net — including the community health centers, Medicaid and Medicare — than other states, even as the federal government picks up a smaller share of the tab.

There are serious concerns about how they and other health service providers will begin even basic recovery in many places where diesel is still scarce and communication almost nonexistent.

The immediate problems are severe. But even once clean water and power are restored, the concerns will be far from over. Puerto Rico’s health system was in financial crisis going into the storm. And because Puerto Rico is a territory as opposed to a state, its safety net — which includes community health centers and programs like Medicaid and Medicare — receives far less help from the federal government than those in the states, and the local government currently has much less flexibility to step in during crises.

Read the full article by Anna Maria Barry-Jester at FiveThirtyEight