Archbishop Roberto González Nieves of San Juan, Puerto Rico, has called on the United States Congress to act to help resolve the island’s financial crisis. With over $70 billion in outstanding debt, since 2015 the island has defaulted on several repayments.

The crisis has been painful for the people of the island, where over 40 percent of the population lives in poverty, and over 12 percent are unemployed.

Puerto Rico is a self-governing territory of the United States. Its population holds U.S. citizenship, but they cannot vote for president, and they have only one non-voting delegate in the U.S. Congress.

In a letter to Congress signed by González and Reverend Heriberto Martínez-Rivera, the Secretary General of Puerto Rico’s Bible Society and Coordinator of the Ecumenical and Interfaith Coalition of Puerto Rico, the two religious leaders said the crisis “continues to affect all of Puerto Rico’s people, in particular the poor and our children.”

González and Martínez-Rivera thanked Congress for the progress made in restructuring the island’s debt and other measures taken to help protect the territory’s people, including funding Puerto Rico’s Medicaid program.

According to the Jubilee USA Network, which promotes debt relief around the world, a higher proportion of Puerto Rico’s population relies on Medicaid than in the 50 U.S. States.

“Disparity in coverage drives doctors and residents to move from the island to one of the states,” wrote Eric LeCompte, the Jubilee USA Network’s executive director, in a July 26 letter to Congress.

“Federal funding for Puerto Rico’s Medicaid program should mimic coverage for citizens who live in the states, utilizing the same formula to determine the share of federal funding and including no cap on the amount of federal funding,” LeCompte said.

In their August 2 letter, González and Martínez-Rivera asked Congress to act on several of the proposals of the Congressional Task Force on Economic Growth in Puerto Rico, many of which address the discrepancies in law between Puerto Rico and states.

These include reimbursing Puerto Rico’s Medicaid program based on per capita income, as states are reimbursed; the inclusion of an automatic opt-in to Medicare Part B for citizens in Puerto Rico, as is done in the states; and extending the federal Child Tax Credit (CTC) to Puerto Rico to families with one or two children in Puerto Rico and the Earned Income Tax Credit (EITC).

“The CTC protects children who are at risk of falling into poverty, and it would pump nearly 3 billion dollars into Puerto Rico’s economy over the next decade. EITC has been shown to increase labor force participation and reduce child poverty; it can be a much needed anti-poverty tool for low-income families on the island,” the letter reads.

González and Martínez-Rivera said Puerto Rico and other jurisdictions find themselves in crisis because of the need for U.S. laws that promote responsible lending and borrowing.

“As we continue to work together to resolve Puerto Rico’s current crisis, we also want to prevent the next crisis,” – the letter continues  – “We want to prevent financial crises that impact all children in our world and we invite you to also work with us on these broader stewardship and preventive measures.”

Currently, the 3.4 million residents of Puerto Rico are exempt from certain federal laws, and have certain tax advantages from not living in a state.

If it became a state, the territory would be eligible for billions more in federal funds, increased Social Security and Medicare benefits, and the ability for government agencies and municipalities to file for bankruptcy – in addition to the ability to vote for president and have voting representatives in the House of Representatives and Senate.

The economic crisis led the government to call a non-binding referendum on Puerto Rico’s status and relationship with the United States, which took place on June 11. It was the fifth such referendum held on the island (the others took place 1967, 1993, 1998, and 2012).

Over 97 percent of those who took part (turnout at 23 percent was historically low) voted to become the 51st state, the highest percentage ever.

However, the territorial government would have to formally request statehood from Congress, which is unlikely to happen in the near future.