My friend is married to a Puerto Rican woman and moved there after Miami’s economy went south after 2008. He has his own small construction business, speaks enough Spanish to manage local workers, and does a lot of work for investors who are upgrading buildings and condos for mainlanders to buy and or live in. Certainly it would be wise to know some Spanish and learn more if moving there. At this point, based on what I have been told, I think it still makes sense for healthy retirement, perhaps not with significant chronic illness. I will have to find out more about medical treatment there for people with mainland retirement incomes.
Healthcare here is pretty good and up to mainland standards, but costs can be much lower. Only thing is, there is a shortage of certain specialties, which translate into long waits. For example, orthopedic surgeons are in short supply, and if you get into an accident with broken bones, you could have to wait 24, 36 hours for a cast. More if you need surgery.