It’s been 12 weeks and counting, and Puerto Rico still flounders in the aftermath of Hurricane Maria, left to beg for federal help. The politics and indifference underlying the island’s desperation recall the lyrics of Stephen Sondheim 60 years ago in “West Side Story”:

Nobody knows in America

Puerto Rico’s in America!

The plot of that Broadway musical was rooted in the great migration in the 1950s as Puerto Ricans — American citizens in good standing — fled hardship on their beloved commonwealth island for fresh opportunity and better government benefits in mainland states. A similar diaspora occurred during the recent recession, when 400,000 migrated. And now, thousands upon thousands more have been leaving each week as the island staggers. Florida alone has received more than 230,000 Puerto Ricans since the Sept. 20 hurricane, and experts predict that the outflow to places like New York and Pennsylvania could increase by more than 300,000 in the next two years unless a radical rebuilding takes place for Puerto Rico’s 3.4 million residents.

The Trump recovery imprint has been far clearer in Gulf Coast states hit by hurricanes this year than on an island that has so little political clout. A double standard in the law was quickly clear after the storm when a federal cap on Puerto Rico’s food stamps limited the amount of emergency food aid. Texas and Florida had no such restraints after their hurricanes.

As of last week, only about 60 percent of Puerto Rico’s power had been restored. Power remains the key to ever regaining normalcy in business, education and home life. But the island is suffering the longest blackout in United States history. An estimated 700 temporary generators are providing emergency power, with officials hoping for something more permanent no earlier than next summer.

The island was reeling under $74 billion in debt even before the hurricane hit, and its news tends to get worse, not better. Its government counted a death toll of 64 in the first 42 days after the storm, but a detailed survey by The Times found that 1,052 more people than usual had died. More lives are at risk now, with older residents and those with chronic health conditions particularly threatened as the on-again-off-again power grid affects vital medical machinery.

Nearly half of Puerto Rico’s residents rely on Medicaid, which is not as well funded federally on the island as it is in the states. The problems are compounded by a looming financial crisis that experts say could leave a quarter of the island’s residents without medical care early next year unless Congress and the Trump administration extend special help.

Washington caps the island’s Medicaid assistance. This means that while federal revenue covers 75 percent of the Medicaid bill for low-income states like Mississippi, Puerto Rico gets only about 15 to 20 percent coverage. So it resorts to local budgeting and more debt, thereby worsening the bankruptcy spiral.

The tax bill working its way through Congress could make things worse, according to island officials. They fear Puerto Rico’s status as a “foreign jurisdiction” would expose it to a devastating new 20 percent import tax on products sold to the states. This would mean more business flight and closings, and the loss of tens of thousands of jobs.

The shaky island government, spendthrift in the past, will have to convince Washington that it is reform-minded, as with the recent resignation of the head of the dysfunctional power authority. The island has requested $94.4 billion in federal rebuilding aid, including $17.8 billion to replace its power grid and $31.1 billion for housing. So far, about $5 billion has been approved by a Republican-dominated Congress far more preoccupied with cutting upper-bracket taxes than helping troubled Americans.

In the meantime, the exodus continues. “Everyone there will have moved here,” Anita sings in “West Side Story.” The current debate on the island has a more anguished edge about whether to go or stay. “Yo no me quito” (“I’m not quitting”) has become the vow of those determined to stay to work for a recovery that is hardly in sight.

—The New York Times, Dec. 17, 2017