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Lawmakers agreed to extend health aid to Puerto Rico as part of a $1.1 trillion spending bill that they're racing to approve this week, which would mark the first step by Congress to help the Caribbean island cope with an escalating debt crisis. The legislation would increase payments to hospitals on the island and provide bonus Medicare payments to doctors and medical facilities that adopt electronic health record-keeping, according to the text of the bill posted early Wednesday on the House website. The spending measure is part of a fiscal plan that would avert a U.S. government shutdown and revive a series of expired tax breaks. (Miller, Wasson and Rowley, 12/16)

Drowning in $73 billion of debt, Puerto Rico had hoped Congress would cast it a lifeline in the end-of-the-year spending bill. Instead, the territory got next to nothing. The omnibus bill did include some good news for Puerto Rico, in the form of enhanced Medicare reimbursement rates that are projected to bring in more than $900 million to the island’s faltering health-care system over the next decade. But that is small consolation for Puerto Rico. (Mufson and Fletcher, 12/16)