Puerto Rico faces a number of significant challenges related to its fiscal stability, economic well-being, and population loss. Complementing a separate environmental scan, this brief explores how these challenges could undermine Puerto Rico’s health care infrastructure and negatively impact population health in Puerto Rico. This report relays insights from interviews with stakeholders involved in efforts to evaluate, maintain, and improve access to health care in Puerto Rico. The report describes the economic, social, and federal and commonwealth policy context and then summarizes stakeholder perceptions of the major barriers to access to health care services. The report also discusses the implications of its findings for health care reforms in Puerto Rico.