| R 379 |
| 2024 -- S 3157 Enacted 06/12/2024 |
| S E N A T E R E S O L U T I O N |
| RESPECTFULLY REQUESTING HEALTHSOURCE RI (HSRI) TO CONVENE A WORKING GROUP TO STUDY THE ISSUE OF AFFORDABILITY OF COVERAGE IN THE RHODE ISLAND HEALTH INSURANCE INDIVIDUAL MARKET AND TO PROVIDE RECOMMENDATIONS ON THE DESIGN OF A STATE-BASED PROGRAM TO PROVIDE AFFORDABILITY ASSISTANCE TO RHODE ISLANDERS ENROLLED IN PLANS THROUGH THE HSRI EXCHANGE |
Introduced By: Senator Joshua Miller |
| Date Introduced: June 11, 2024 |
| WHEREAS, Many Rhode Islanders report serious challenges in accessing health care |
| services due to high and rising deductibles, out-of-pocket costs, and monthly health insurance |
| premiums; and |
| WHEREAS, According to the 2024 Rhode Island Market Summary published by the |
| Office of the Health Insurance Commissioner, Rhode Islanders enrolled in health insurance |
| coverage through the individual market pay higher cost sharing than Rhode Islanders enrolled in |
| health insurance coverage through the small or large group markets; and |
| WHEREAS, Research studies have demonstrated that higher cost sharing has been shown |
| to decrease consumers’ utilization of needed medical services, including preventive care and |
| essential drugs; and |
| WHEREAS, Increases in consumer cost sharing are seen to influence adverse outcomes |
| for vulnerable populations, including the elderly, chronically ill, and low income; and |
| WHEREAS, HealthSource RI (HSRI) documented in its 2022 Health Information Survey |
| a 21 percent increase in out-of-pocket costs between 2020 and 2022, noting this was “the highest |
| reported out-of-pocket spending since the [HSRI] survey began in 2012”; and |
| WHEREAS, In the same HSRI 2022 Health Information Survey, 14.9 percent of Rhode |
| Islanders reported that, despite having health insurance coverage, they experienced problems |
| paying medical bills; and |
| WHEREAS, HSRI reports that after the end of the COVID-19 public health emergency, |
| at least 14,000 low- and middle-income Rhode Islanders who had retained Medicaid coverage |
| during the pandemic transitioned to HSRI individual market coverage where premiums and out- |
| of-pocket costs may result in individuals foregoing needed medical care or face unexpectedly |
| high bills for medical treatment; and |
| WHEREAS, The Kaiser Family Foundation has noted that “for people and families with |
| limited assets, even a relatively small unexpected medical expense can be unaffordable”; and |
| WHEREAS, Federal enhanced advance premium tax credits were established under the |
| 2021 American Rescue Plan and extended by the 2022 Inflation Reduction Act, helping expand |
| health insurance premium affordability support for millions of Americans and helping reduce |
| uninsured rates in Rhode Island to an all-time low of 2.9 percent; and |
| WHEREAS, Federal enhanced advance premium tax credits are scheduled to expire in |
| December 2025, potentially jeopardizing years of coverage gains and making health insurance |
| unaffordable for many middle-income Rhode Islanders; and |
| WHEREAS, Without this federal support some Rhode Islanders could be expected to pay |
| up to 36 percent of their income simply to enroll into health insurance, thereafter facing |
| additional charges for out-of-pocket medical costs; and |
| WHEREAS, Other states have established successful state-based programs to lower |
| health insurance premiums and out-of-pocket health care costs for low- and middle-income |
| residents, including Massachusetts, Colorado, and Washington; and |
| WHEREAS, The urgency of the potential increase in health insurance premiums for |
| many middle-income Rhode Islanders, particularly those who have recently lost Medicaid |
| coverage held through the COVID-19 pandemic, necessitates immediate action to design a Rhode |
| Island state-based affordability program and the funding mechanism for such a program; now, |
| therefore be it |
| RESOLVED, That this Senate of the State of Rhode Island hereby respectfully requests |
| HealthSource RI (HSRI) to convene a working group to study the issue of affordability of |
| coverage in the Rhode Island health insurance individual market and to make recommendations |
| on the design of a state-based program to provide affordability assistance to Rhode Islanders |
| enrolled in plans through the HSRI exchange; and be it further |
| RESOLVED, That this Senate hereby requests that HSRI invites participation in this |
| working group from members of the Exchange Advisory Board established by § 42-157-7 of the |
| General Laws, and further invites additional participants to ensure meaningful participation from |
| each of the following groups: the Office of the Health Insurance Commissioner, the Executive |
| Office of Health and Human Services, health insurance carriers, health care providers (including |
| primary care providers, behavioral health care providers, and hospitals), health care consumers |
| and health care consumer advocacy organizations, and businesses which purchase or otherwise |
| provide health insurance coverage for their employees; and be it further |
| RESOLVED, That this Senate hereby requests that the working group considers and |
| issues recommendations regarding mechanisms that directly address both the monthly premium |
| cost of health insurance obtained through HSRI and the out-of-pocket costs paid by enrollees |
| upon receipt of health care services, currently addressed by federal advance premium tax credits |
| and cost-sharing reductions, respectively; and be it further |
| RESOLVED, That this Senate hereby requests that in its study and recommendations, the |
| working group specifically addresses the impact of the expiration of federal enhanced advance |
| premium tax credits established under the American Rescue Plan and extended by the Inflation |
| Reduction Act, which are currently expected to expire at the end of calendar year 2025; and be it |
| further |
| RESOLVED, That this Senate hereby requests that the working group delivers its |
| recommendations as to the design of such state-based affordability program based on a total |
| funding amount of $20 million, and to additionally deliver recommendations as to how such |
| design would be modified if the total funding amount were to be halved (i.e. $10 million) or |
| doubled (i.e. $40 million); and be it further |
| RESOLVED, That this Senate hereby requests that the working group additionally |
| studies and reports to the Senate as to potential funding mechanisms which could be designed and |
| established to pay for such state-based affordability program and the positive and negative |
| attributes of each funding mechanism, including, but not limited to, state general revenue, |
| assessments on health insurance issuers, other assessments on health care industry entities, special |
| assessments, proceeds from existing or new excise taxes, funds from the Rhode Island Health |
| Insurance Mandate, and any federal funding source identified; and be it further |
| RESOLVED, That this Senate hereby requests that HSRI submits a report on the |
| recommendations delivered by the working group to the President of the Senate and the Governor |
| on or before January 31, 2025; and be it further |
| RESOLVED, That the Secretary of State be and hereby is authorized and directed to |
| transmit duly certified copies of this resolution to HealthSource RI, the Office of the Health |
| Insurance Commissioner, the Executive Office of Health and Human Services, and the Honorable |
| Daniel McKee, Governor of the State of Rhode Island. |
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| LC006267 |
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