2025 -- H 5205

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LC000850

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

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A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR

CHILDREN AND PREGNANT WOMEN

     Introduced By: Representatives Slater, Diaz, Kislak, Potter, Cruz, and Cotter

     Date Introduced: January 24, 2025

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

SECTION 1. Legislative findings.

The general assembly hereby finds as follows:

(1) Stable health coverage for infants and young children helps ensure children receive high-

quality and timely preventive health care, including vaccinations and screenings, routine care for

illnesses, specialized health care when needed, and emergency health care services;

(2) Routine physical and developmental screenings that occur over eleven (11) recommended

scheduled well-child preventive health care visits from birth until age three (3) years help to identify

potential developmental delays and disabilities, as well as emerging vision, hearing, dental, and

physical conditions, as well as developmental delays and disabilities, as early as possible so that

further appropriate evaluations, interventions, and treatments can be provided;

(3) Young children experience six (6) to nine (9) acute, short-term illnesses per year that can

require a health care visit and treatment, including respiratory viruses, gastrointestinal illness,

croup, ear infections, conjunctivitis, fevers, and skin rashes and some young children have chronic,

long-term illnesses that require frequent health care visits for evaluations, diagnosis, treatment, and

management of these chronic conditions;

(4) At least sixty percent (60%) of infants and young children under the age of three (3) in

Rhode Island have Medicaid/Rite Care coverage;

(5) Children may lose their health coverage at the required yearly redetermination of

eligibility due solely to administrative barriers and then requalify within a short period of time

(commonly referred to as “churn”); nationally, 44% of children who were terminated from

Medicaid in 2018 re-enrolled within twelve (12) months.

(6) Continuous eligibility for Medicaid (RIte Track/RIte Care) during infancy and the early

childhood years will prevent gaps in coverage, ensuring that children remain enrolled in their health

plan with consistent coverage so that they can receive timely and necessary preventative, routine,

and emergency care services and treatment for identified conditions to promote healthy

development; and

(7) Continuous eligibility also promotes health equity by limiting gaps in coverage for low-

income children who experience disproportionate rates of health disparities, particularly children

of color.

(8) As of January 15, 2025, eight states (HI, MN, NC, NM, NY, OR, PA, and WA) are

implementing continuous coverage for young children up to age six, one state is implementing

continuous coverage up to age three (CO) and three states and the District of Columbia have taken

administrative or legislative action to implement continuous coverage for children up to age four

(OH), age five (CA), and age six (IL and DC).

     SECTION 2. The title of Chapter 42-12.3 of the General Laws entitled "Health Care for

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

CHAPTER 42-12.3

Health Care for Children and Pregnant Women

CHAPTER 42-12.3

ACT TO STABILIZE HEALTH COVERAGE FOR YOUNG CHILDREN

     SECTION 3. Chapter 42-12.3 of the General Laws entitled "Health Care for Children and

Pregnant Women" is hereby amended by adding thereto the following section:

     42-12.3-17. Continuous coverage for children up to age three (3).

     (a) Individuals up to age three (3) years who are enrolled in RIte Track/RIte Care pursuant

to this chapter shall qualify for continuous eligibility until the end of the month in which their third

birthday falls. Continuous eligibility shall end if the individual is no longer a resident of Rhode

Island, the parent or guardian of the individual requests termination of eligibility, the individual

dies or the executive office of health and human services determines that eligibility was erroneously

granted.

     (b) The executive office of health and human services shall seek any necessary

amendments to the Rhode Island Medicaid Section 1115 waiver to implement continuous

eligibility.

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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

***

     This act would provide children up to age three (3) with continuous coverage eligibility for

RIte Track/RIte Care so that they are not at risk of losing coverage at the yearly redetermination

due solely to administrative barriers.

     This act would take effect upon passage.

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