2022 -- S 2549

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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 -- HEALTH CARE FOR

CHILDREN AND PREGNANT WOMEN--EQUALITY IN ABORTION COVERAGE

     

     Introduced By: Senators Valverde, Mack, Sosnowski, Acosta, Coyne, Miller, Kallman,
Pearson, Cano, and Murray

     Date Introduced: March 01, 2022

     Referred To: Senate Judiciary

     It is enacted by the General Assembly as follows:

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     SECTION 1. Legislative findings. The general assembly hereby finds and declares that:

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     (1) In enacting the Reproductive Privacy Act in 2019, the general assembly recognized the

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importance of protecting a person's right to reproductive health care. However, exercising that right

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can be illusory for people of limited financial means.

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     (2) Funding restrictions on abortion coverage interfere with an individual's personal

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decision-making, with their health and well-being, and with their constitutionally protected right to

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a safe and legal medical procedure.

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     (3) Restrictions on abortion coverage have a disproportionate impact on low-income

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residents, immigrants, people of color, and young people who are already disadvantaged in their

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access to the resources, information, and services necessary to prevent an unintended pregnancy or

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to carry a health pregnancy to term.

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     (4) Numerous other states provide abortion coverage in their Medicaid programs and in

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their state employee insurance plans.

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     (5) The purpose of this legislation is to promote equity in access to reproductive health

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care.

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     SECTION 2. Section 42-12.3-3 of the General Laws in Chapter 42-12.3 entitled "Health

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Care for Children and Pregnant Women" is hereby amended to read as follows:

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     42-12.3-3. Medical assistance expansion for pregnant women/RIte Start.

 

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     (a) The director of the department of human services is authorized to amend its Title XIX

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state plan pursuant to Title XIX of the Social Security Act to provide Medicaid coverage and to

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amend its Title XXI state plan pursuant to Title XXI of the Social Security Act to provide medical

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assistance coverage through expanded family income disregards for pregnant women persons

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whose family income levels are between one hundred eighty-five percent (185%) and two hundred

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fifty percent (250%) of the federal poverty level. The department is further authorized to

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promulgate any regulations necessary and in accord with Title XIX [42 U.S.C. § 1396 et seq.] and

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Title XXI [ 42 U.S.C. § 1397aa et seq.] of the Social Security Act necessary in order to implement

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said state plan amendment. The services provided shall be in accord with Title XIX [42 U.S.C. §

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1396 et seq.] and Title XXI [ 42 U.S.C. § 1397aa et seq.] of the Social Security Act.

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     (b) The director of the department of human services is authorized and directed to establish

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a payor of last resort program to cover prenatal, delivery and postpartum care. The program shall

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cover the cost of maternity care for any woman person who lacks health insurance coverage for

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maternity care and who is not eligible for medical assistance under Title XIX [42 U.S.C. § 1396 et

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seq.] and Title XXI [ 42 U.S.C. § 1397aa et seq.] of the Social Security Act including, but not

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limited to, a noncitizen pregnant woman person lawfully admitted for permanent residence on or

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after August 22, 1996, without regard to the availability of federal financial participation, provided

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such pregnant woman person satisfies all other eligibility requirements. The director shall

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promulgate regulations to implement this program. Such regulations shall include specific

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eligibility criteria; the scope of services to be covered; procedures for administration and service

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delivery; referrals for non-covered services; outreach; and public education. Excluded services

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under this subsection will include, but not be limited to, induced abortion except in cases of rape

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or incest or to save the life of the pregnant individual.

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     (c) The department of human services may enter into cooperative agreements with the

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department of health and/or other state agencies to provide services to individuals eligible for

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services under subsections (a) and (b) above.

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     (d) The following services shall be provided through the program:

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     (1) Ante-partum and postpartum care;

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     (2) Delivery;

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     (3) Cesarean section;

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     (4) Newborn hospital care;

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     (5) Inpatient transportation from one hospital to another when authorized by a medical

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provider; and

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     (6) Prescription medications and laboratory tests.

 

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     (e) The department of human services shall provide enhanced services, as appropriate, to

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pregnant women persons as defined in subsections (a) and (b), as well as to other pregnant women

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persons eligible for medical assistance. These services shall include: care coordination, nutrition

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and social service counseling, high risk obstetrical care, childbirth and parenting preparation

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programs, smoking cessation programs, outpatient counseling for drug-alcohol use, interpreter

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services, mental health services, and home visitation. The provision of enhanced services is subject

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to available appropriations. In the event that appropriations are not adequate for the provision of

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these services, the department has the authority to limit the amount, scope and duration of these

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enhanced services.

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     (f) The department of human services shall provide for extended family planning services

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for up to twenty-four (24) months postpartum. These services shall be available to women persons

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who have been determined eligible for RIte Start or for medical assistance under Title XIX [42

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U.S.C. § 1396 et seq.] or Title XXI [ 42 U.S.C. § 1397aa et seq.] of the Social Security Act.

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     (g) Any person eligible for services under subsections (a) and (b) of this section, or

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otherwise eligible for medical assistance under title XIX [42 U.S.C. § 1396 et seq.] and title XXI

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[42 U.S.C. § 1397aa et seq.] of the Social Security Act, shall also be entitled to services for any

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termination of pregnancy permitted under § 23-4.13-2; provided, however, that no federal funds

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shall be used to pay for such services, except as authorized under federal law.

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     SECTION 3. Section 36-12-2.1 of the General Laws in Chapter 36-12 entitled "Insurance

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Benefits" is hereby repealed.

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     36-12-2.1. Health insurance benefits -- Coverage for abortions excluded.

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     (a) The state of Rhode Island shall not include in any health insurance contracts, plans, or

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policies covering employees, any provision which shall provide coverage for induced abortions

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(except where the life of the mother would be endangered if the fetus were carried to term, or where

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the pregnancy resulted from rape or incest). This section shall be applicable to all contracts, plans

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or policies of:

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     (1) All health insurers subject to title 27;

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     (2) All group and blanket health insurers subject to title 27;

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     (3) All nonprofit hospital, medical, surgical, dental, and health service corporations;

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     (4) All health maintenance organizations; and

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     (5) Any provision of medical, hospital, surgical, and funeral benefits and of coverage

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against accidental death or injury when the benefits or coverage are incidental to or part of other

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insurance authorized by the statutes of this state.

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     (b) Provided, however, that the provisions of this section shall not apply to benefits

 

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provided under existing collective bargaining agreements entered into prior to June 30, 1982.

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     (c) Nothing contained herein shall be construed to pertain to insurance coverage for

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complications as the result of an abortion.

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     SECTION 4. 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 -- HEALTH CARE FOR

CHILDREN AND PREGNANT WOMEN--EQUALITY IN ABORTION COVERAGE

***

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     This act would provide for abortion coverage in the Medicaid program and repeal the

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abortion coverage exclusion for state employee insurance plans.

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     This act would take effect upon passage.

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