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