Congressional leaders should think about the 4 million Americans who live in the U.S. territories when they are drafting the final version of the health bill, Rep. Nydia Vel?zquez writes in a letter sent to House Speaker Nancy Pelosi.

Vel?zquez, D-N.Y., wrote the letter on behalf of herself and members of the Congressional Black Caucus and the Congressional Asian Pacific American Caucus.

House and Senate leaders now are trying to reconcile the differences between H.R. 3962, the House health bill, and H.R. 3950, the Senate health bill.

The bills include a number of provisions that could affect the residents of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands, Vel?zquez writes.

The Senate version "discriminates against U.S. citizens living in these U.S. jurisdictions by denying them access to the health insurance exchange and substantially decreasing the Medicaid funding as compared to the House approved version," Vel?zquez writes. "These policies not only create a separate standard of care, they are clearly unjust and clash with the goal of providing access to care for all Americans."

Access to the exchange system, which would match consumers with health insurance plans and allocate health insurance subsidies, is crucial to reducing inequality in access to health coverage, Vel?zquez writes.

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