Our STATE PRIORITIES reflect our work to protect and promote access to quality, affordable healthcare for all.
In 2021, we will continue our advocacy to achieve policies that promote health care as a right, with quality, access, affordability, and equity at the forefront. This year, we will lead the effort to enshrine the Affordable Care Act’s consumer protections in state law.
Consumer protections are a cornerstone of the Affordable Care Act’s effort to ensure quality coverage for a fair price to everyone, regardless of how they get their coverage. We must balance the requirement for coverage with guarantees in state law that ensures coverage is both accessible and meaningful. A set of legislative proposals before the General Assembly would codify the protections. House Bill 5843 is inclusive of the ACA’s interdependent consumer protections and are mirrored by a series of stand-alone bills that address individual components to:
Protect people with pre-existing conditions by guaranteeing the issuance and renewal of insurance policies, so that patients cannot be denied coverage, even if sick. (H5843, H5441, S5a)
Require that plans cover 10 essential health benefits, including preventive services, maternity care, hospital stays, mental health and substance use treatment, among others. (H5483, H5441, S5a)
Require no cost-sharing, such as co-pays or other out-of-pocket costs, for preventive services such as wellness visits and annual screenings. (H5843, H5441, S5a)
Prohibit annual limits and lifetime dollar caps on coverage for essential benefits. (H5843, H5651, S)
Prevent insurers from charging increased premiums based on gender. (H5483, H5763, S3)
In addition, we support legislative proposals to improve healthcare equity and access to care, including the following proposals that will:
Improve the state’s Telemedicine Coverage Act (S4SubA2/H6032): Experience during the pandemic has demonstrated how telemedicine can help improve access to health care. Providing a framework in state law for permanent access to telemedicine can help move Rhode Island forward in alleviating barriers people face in accessing care, including work hours, lack of child care and transportation.
Provide coverage for community-based doula care (S484/H5929): Institutional racism and implicit bias drive health inequity. In Rhode Island, Black women are 42% more likely to experience a severe complication at delivery than White women. The infant mortality rate for Black infants in Rhode Island is three times that of White infants. A key strategy to address this issue is making doula services eligible for reimbursement through Medicaid and private insurance and investing in building and sustaining the doula workforce.
Target racial disparities and address gaps in access to Medicaid, including:
- Coverage for new mothers to 12 months postpartum: The importance of post-partum care cannot be stressed enough: more than half of pregnancy-related maternal deaths occur after delivery, with 13% occurring between 42 and 365 days after birth. In Rhode Island, Medicaid maternity coverage ends at 60 days postpartum, and many women lose eligibility for continued Medicaid coverage and must seek coverage elsewhere or become uninsured, creating a gap in coverage.
- Coverage for all income-eligible children (H5714): Currently, 98.1% of Rhode Island children have health insurance coverage. To achieve our goal of covering all kids, we must restore access to RIte Care for income-eligible children who are undocumented immigrants. All children need access to health care that supports their healthy growth and development and promotes school success.
- Coverage for the elderly and disabled (S492/H5790): This bill would increase the income eligibility limit for medical assistance coverage for seniors and disabled individuals who life in the community from one hundred percent (100%) to one hundred thirty-three percent (133%) of federal poverty level.
Support investments in long-term care services to allow seniors and people with disabilities to live safely in the community and in residential facilities: The dire situation in many of our state’s nursing homes that have existed for some time was exacerbated during COVID-19. The Nursing Home Safe Staffing and Quality Care Act (S2/H5012) will help provide quality of life and dignity for residents of nursing homes and provide fair compensation for the staff who serve them.
Improve access to behavioral health services: Implement parity in reimbursement rates paid to behavioral health professionals (H5546/S*): Insurers continue to pay behavioral health professionals less than Medicare allowable rates, limiting provider enrollment in payer networks and contributing to our state’s inadequate provider network. There has been demonstrated success in addressing provider shortages in primary care through mandated higher reimbursement; it is time to enact a similar change in behavioral healthcare.
Improve access to colorectal cancer screenings (H5432/S383): Nearly all colorectal cancers are preventable and regular screening is the most effective way to detect them early. In Rhode Island, when a colonoscopy is required after an abnormal less invasive screening, it may be subject to cost-sharing. As affordability is most often cited as the reason for not being screened, we support requiring preventative colorectal cancer screenings for those forty-five and over, even colonoscopies following a less invasive test, to be covered by insurance.
The Protect Our Healthcare Coalition also supports initiatives to reduce HEALTH DISPARITIES – most specifically we must expand access to safe, affordable housing.
Research demonstrates that safe affordable homes are critical to improving health outcomes and an important component in managing health risk. Rhode Island must prioritize housing as a top public health initiative. The legislation to end discrimination based on source of income is one step. In addition, the state must establish a permanent funding stream for affordable housing production and expend the recently approved bond funds as soon as possible to accelerate the development of affordable housing and address the current crises of homelessness.
Finally, the Protect Our Healthcare Coalition believes our state must ensure the top 1% of earners contribute their fair share towards much-needed revenue for Rhode Island (H5227/S326) to help address disparities in access to housing, food, healthcare, and other critical services for residents.