Our STATE PRIORITIES reflect our work to protect and promote access to comprehensive, quality, affordable healthcare for all.
In 2022, we will continue our advocacy to achieve policies that promote health care as a right, with quality, access, affordability, and equity at the forefront, including the following:
Codify ACA health insurance consumer protections in state law. Despite the ACA being upheld by the U.S. Supreme Court in 2021, individual components of the ACA remain at risk to erosion. New Jersey, among other states, has already taken action to codify key provisions of the law in their own statutes and it is time for Rhode Island to follow suit. We must balance the state mandated requirement for coverage with guarantees in state law that ensure coverage is both accessible and meaningful by enacting the following proposals. House Bill 7500 is inclusive of the full range of interdependent consumer protections mirrored by the series of stand-alone bills outlined below. Because the bills adopt current health insurance practices, the proposals are budget neutral.
- 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. (H7560, S2080)
- Require that plans cover 10 essential health benefits, including preventive services, maternity care, hospital stays, mental health and substance use treatment, among others. (H7560, S2080)
- Prohibit cost sharing, such as co-pays or other out-of-pocket costs, for preventive services including wellness visits, contraception, and annual wellness screenings. (H7560, S2080)
- Prohibit annual limits and lifetime dollar caps on coverage for essential benefits. (H7183, S)
- Mandate coverage for FDA-approved contraceptive drugs, devices and other products (H7631, S2327)
We also support the following proposals to improve healthcare equity, access to comprehensive care, coverage affordability, and state investments in the care economy:
Target racial disparities and address gaps in Medicaid, Medicare, and our state’s care economy, including:
- Expand coverage for new mothers for 12 months postpartum: (H7290, S2202, Budget Article 12, Section 7) The importance of postpartum 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, all pregnant women are eligible for Medicaid regardless of immigration status if income is less than 258% of the federal poverty level. However, Medicaid postpartum coverage ends at 60 days. After that many women lose Medicaid coverage either because of income or immigration status and may be uninsured during the first year of their child’s life. The bills/budget Article will extend coverage from 60 days to 12 months for all women who give birth while enrolled in Medicaid. Beginning April, 2022, the federal government will share in the cost of postpartum coverage for most of these new moms.
- Expand Medicaid to include all income-eligible children: (H7484, S2187, Budget Article 12, Section 7) 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.
- Increase the income limits for the Medicare Premium Savings Programs: (H7445, S2196) One in three older Rhode Islanders have income below $30,000, near just twice the poverty level. Medicare premiums ($2,041 annually), deductibles and out-of-pocket costs take a big bite out of beneficiaries’ fixed incomes. The Medicare premium savings programs cover some of these costs for low-income seniors and people with disabilities, leaving more income for rent, food and other necessities.
- Expand investments in home and community-based services: The Governor’s proposed 2023 budget undermines expansion as explained below. We support the RI Voices for Better Health (VBH) effort to fight for the funding needed to expand state investments:
- For many years, Rhode Island state law (Perry/Sullivan) has required yearly investment in home and community-based services from savings accrued from reducing reliance on facility-based care. The federal government has recently provided states with additional Medicaid matching funds to encourage and allow them to expand home and community based long term care services. The Governor’s budget proposes substituting these new funds for the required investment under the Perry/Sullivan law. This significantly reduces the funds available for these critical services (including, for example, wage increases for direct care providers). (Budget article 12, section 6).
- The Governor’s budget fails to include an increase in wages for home health workers as recommended by EOHHS. Voices for Better Health will seek to increase wages to $18/hour, consistent with wages paid to other direct care workers.
- Improve Medicaid and state HHS program rate setting to support the workforce and enhance access to quality services for Rhode Islanders. (S2311 / H7180)
Achieve parity in reimbursement rates paid for behavioral health services: (H/S2471): 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 continuum of behavioral care. This bill will increase reimbursement rates paid for behavioral health services by Medicaid and commercial plans.
Support equitable access to reproductive healthcare: Equality in Abortion Coverage Act: (H7442 / S) This Act will eliminate harmful laws that prevent people enrolled in Medicaid and more than 17,000 state employees (and their dependents) from using their insurance to cover abortion. These limitations have the most significant impact on people of color and people with low incomes. No one should be denied coverage for abortion because of who they are, where they work, or how much money they make.
Reduce patient co-pays for specialty drugs: (H7666/S2608) Thousands of Rhode Islanders struggle with chronic conditions that increases their need for prescription specialty drugs to stay well. In 2016, 25% of Rhode Islanders reported they stopped taking a prescribed drug due to cost. Most specialty drugs do not have substitutes to create competition and help lower their prices and are defined as a prescription priced at $670 or more per month. This bill would cap a patient’s out-of-pocket costs for a specialty drug at no more than $150 per month.
The Protect Our Healthcare Coalition also supports initiatives to reduce HEALTH DISPARITIES – most specifically we must expand access to safe, affordable housing.
- 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. We support appropriating sufficient funds in the 2023 state budget and changes to policies and programs that would significantly move the needle on developing a range of affordable housing, including supportive housing and investments to end homelessness.
- Improve access to healthy foods: One in four Rhode Island households lack adequate food. The Supplemental Nutrition Assistance Program (SNAP) helps Rhode Island families afford a basic diet. We support the NourishRI Retail SNAP Incentive Program to provide SNAP members an automatic 50% discount on fresh fruit and vegetable purchases when paying with their benefits at a retail grocery store. (S2310 / H7490)
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 (H7440 /S2264) to help address disparities in access to housing, food, healthcare, and other critical services for residents.