2022 -- S 2896

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LC005722

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

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A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT -- RHODE ISLAND HEALTH

BENEFIT EXCHANGE

     Introduced By: Senators Miller, Goodwin, Kallman, DiPalma, Valverde, Lawson, and
DiMario

     Date Introduced: April 26, 2022

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 42-157 of the General Laws, entitled “Rhode Island Health Benefit

Exchange”, is hereby amended by adding thereto the following section:

     42-157-15. COVID-19 premium payment program.

     (a) Establishment of premium payment program. The exchange may utilize funds

appropriated by the general assembly to the exchange to pay up to three (3) months of health

insurance premiums for an individual who meets the eligibility requirements under subsection (b)

of this section and enrolls in a qualified health plan through the exchange during the individual’s

sixty (60) day special enrollment period specified in subsection (b)(2) of this section.

     (b) Eligibility. An individual is eligible for the premium payment program under subsection

(a) of this section if the exchange determines the individual:

     (1) Was disenrolled from Medicaid upon the end of the COVID-19 public health

emergency or the end of the continuous coverage requirement established under Section 6008(b)(3)

of the Families First Coronavirus Response Act (FFCRA), whichever occurs first;

     (2) Is eligible for a special enrollment period under 45 C.F.R. § 155.420(d)(1) as a result

of being disenrolled from Medicaid; and

     (3) Is eligible for advance payments of the premium tax credit under 45 C.F.R. §

155.305(f).

     (c) Premium payments applied after advance payments of the premium tax credit. The

exchange shall limit premium payment under subsection (a) of this section to the portion of the

premium owed after advance payments of the premium tax credit have been applied. If an

individual elects to accept less than the full amount of advance payments of the premium tax credit

for which the individual is determined eligible under 45 C.F.R. § 155.310(d)(2), the exchange will

not utilize funds under subsection (a) of this section to pay that portion of the premium.

     (d) Duration of program. The premium payment program established by subsection (a) of

this section shall be available to eligible individuals for up to twelve (12) months after the month

in which the COVID-19 public health emergency ends, consistent with the state health official letter

issued by the Centers for Medicaid and Medicare Services on August 13, 2021. If the Centers for

Medicaid and Medicare Services extends the timeframe beyond twelve (12) months, the exchange

may make this premium payment program available to eligible individuals during the extended

period.

     (e) Availability of funds. Notwithstanding subsections (a), (b), (c), or (d) of this section,

the exchange may uniformly restrict, terminate, or otherwise reduce eligibility for the premium

payment program under subsection (a) of this section at any time in the case of limited funding

availability.

     (f) Appeals. Any person aggrieved by the exchange’s determination of eligibility for

premium payment under this section has the right to an appeal in accordance with the procedures

contained within chapter 35 of title 42.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT -- RHODE ISLAND HEALTH

BENEFIT EXCHANGE

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     This act would establish a premium payment program to help individuals and families

transition from expired COVID-19 Medicaid coverage to commercial health insurance, thereby

avoiding a gap in medical coverage.

     This act would take effect upon passage.

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