Three and a half million people live in Puerto Rico. But many more Puerto Ricans, about 5.2 million, live on the U.S. mainland. Over the last decade, crime, the struggling economy and a fiscal crisis have prompted tens of thousands to leave the island each year. Many land in Florida.

At a community center in Orlando this week, Puerto Rican leaders from all over the U.S. gathered at a conference with an ambitious goal: to forge a national political agenda — and flex some political muscle.

Betsy Franceschini, a representative of the island's government, puts their message to Congress and the White House plainly: "If you want our vote, you must listen to us."

After Mexicans, Puerto Ricans are the second-largest Hispanic group in the United States. A million Puerto Ricans live in Florida alone, for instance, about the same number as New York. Large numbers have also settled in Pennsylvania, Texas, New Jersey and other states.

But unlike other Hispanics, as U.S. citizens, Puerto Ricans who move to the mainland arrive here qualified to vote. And Puerto Rico definitely could use some help.

The island's government has been struggling to make payments on more than $72 billion in debt. Puerto Rico's economy has been in a recession for most of the past decade; unemployment is more than twice the national average.

Jose Lopez of Chicago's Puerto Rican Cultural Center says people are moving to the mainland at a rate not seen since an era from 1946 to 1966, when 2 million people left the island.

"We're actually experiencing even that at a higher scale today," Lopez says. "So without a doubt, I believe that for Puerto Ricans, this hits at the core of their very inner soul."

Lopez helped organize the conference and planned it in Florida, in large part because of the importance of the Puerto Rican vote there. There are nearly as many Puerto Ricans in Florida now as Cuban-Americans. In the last election, aided by a strong Puerto Rican turnout, President Obama won the Hispanic vote and carried the state.

Rep. Luis Gutierrez of Illinois, a Democrat, has been working with other members to gain support in Congress for measures to help the island, such as allowing the government there to restructure some of its debt through court-supervised bankruptcy.

Puerto Rico is also facing a healthcare crisis and a shortfall in federal reimbursements for Medicare and Medicaid. Addressing the conference, Gutierrez called on President Obama to make good on a promise he says the president made when the Affordable Care Act was passed, a promise to provide more funds for Puerto Rican healthcare when it was needed.

"Mr. President. it is time to provide the additional funds to the people of Puerto Rico," Gutierrez said to the conference.

Puerto Rico is facing big cuts in federal Medicare payments, while the states are seeing increases. Gutierrez says that makes no sense.

"You cannot continue to cut health care in Puerto Rico because what you are saying to them is, 'Jump on the next airplane and come to Florida, or come to Chicago, or come to New York where you will be treated with equality.' "

Gutierrez and others who represent the interests of Puerto Ricans in Congress are also pressuring the Treasury Department to help the island renegotiate its crushing $72 billion debt. That effort may be bearing fruit. There were reports this week that the Treasury Department is considering setting up and overseeing a debt exchange program for Puerto Rico.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

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