Health insurance must be affordable, comprehensive, and accessible
Rhode Islanders understand how profoundly broken the current healthcare system is and want one that works for all. Health insurance must be affordable and comprehensive so people can access services and care. The Affordable Care Act has helped many Rhode Islanders get health coverage by expanding Medicaid and establishing subsidized commercial coverage through HealthSourceRI. Medicare covers seniors and people with disabilities. Yet these programs are at risk in Washington, and even with them, too many people still struggle to get the care they need because providers are not available or out-of-pocket costs are too high.
In 2025, under the banner of our Campaign for Healthcare Access and Affordability, we advocated for several state legislative priorities with significant success. For an overview of 2025 state legislative victories, including in healthcare, click here.
This year, as devastating federal cuts to HealthSource RI affordability and Medicaid go into effect, we have continued to advocate for state legislation to ensure all Rhode Islanders' access to quality and affordable healthcare.
Strengthen Healthcare AFFORDABILITY, STABILITY, AND ACCESS in response to federal cuts:
The Individual Market Affordability Act (Speakman H7466/Lauria S2255) would restore affordability in the state’s individual health insurance marketplace, HealthSource RI (HSRI). This bill would create a state-based program that would replace expired federal subsidies.
More than 80% of enrollees receive income-based Advanced Premium Tax Credits (APTCs) that make their premiums more affordable. Enhanced APTCs expired at the end of 2025, and those who received income-based APTCs saw their premiums double, on average from 2025 to 2026. From the end of 2025 to the end of Open Enrollment in 2026, nearly 9,500 fewer Rhode Islanders enrolled in HSRI, a nearly 25% decrease. As HSRI reports, “Lower income households will experience the largest percentage impact when 2025 premiums increase . . . heading into 2026.”
The Protect Our Healthcare Act (Donovan H 8137/DiPalma S 2811) would allocate critical funds for uninsured Rhode Islanders' healthcare and the healthcare systems that already care for them.
More than 53,000 Rhode Islanders are expected to lose healthcare due to federal cuts to Medicaid and the expiration of subsidies on the individual health insurance marketplace. The healthcare needs of uninsured Rhode Islanders will Our healthcare providers that already care for uninsured Rhode Islanders cannot care for a tripling of 2024's uninsured population without additional funds. Our state cannot afford to lose any of these safety net providers. Uninsured Rhode Islanders often delay care and have no affordable pathways to many aspects of care, like prescription drugs, mental healthcare, cancer treatments, or scheduled surgeries. This bill would also help fill some of these gaps and provide more affordable options for uninsured Rhode Islanders.
Invest in MEDICAID and MEDICARE to improve access, equity, and affordability:
- Expand the Medicare Savings Programs by eliminating the asset test to improve access and affordability for Rhode Island seniors and people with disabilities (Alzate H 7631)
- Implement the full Social and Human Services Program rate adjustments recommended by the Office of the Health Insurance Commissioner in year one (Shanley H 8183)
- Increase the Medicaid payment rates to 130% of Medicare rates for outpatient pediatric services (Tanzi H 7693/Lauria S 2542)
Improve ACCESS and QUALITY in our state’s healthcare delivery system:
- Address access to behavioral healthcare by strengthening mental health parity rules (Tanzi H7946/Ujifusa S 2687), prohibiting prior authorization for in-network mental health or substance use disorder services (Tanzi H 7943/Ujifusa S 2467), and by standardizing coverage guidelines for mental health and substance use (Tanzi H7945/Lauria S2564).
- Sustain funding for the PediPRN and MomsPRN resource network to ensure quality access to behavioral health support for children and new moms. (Shallcross-Smith H 8268/DiMario S 2562)
- Improve affordable access to medication and vaccines through expanding contraception not subject to cost sharing (Alzate H7923/Euer S 2254), mandating coverage of vaccines recommended by RIDOH without cost sharing (Donovan H 7693/Ujifusa S 2379 Sub A), and requiring coverage of a year of prescription hormone replacement therapy (Donovan H 8245/Murray S 2863)
- Strengthen anti-discrimination protections in healthcare. (Kislak H 7940/LaMountain S 3107)
- Increase frequency of assisted living facility inspections from bi-annually to annually (Donovan H7624/Ujifusa S 2571)
- Regulate data and artificial intelligence use in healthcare by regulating the use of AI in claim and benefit determinations (Donovan H 7190/Ujifusa S 2010) and strengthening data privacy related to gender-affirming care and reproductive healthcare (Knight H 7357/LaMountain S 2129)
- Fund critical healthcare support programs, including Planned Parenthood, the Dual Ombudsman Program (Spears H 7400/DiPalma S 2816), and the Long Term Care Ombudsman Program (Slater H 7059/Tikoian S 2104)
- Ensure the Newport Birthing Center, an essential care provider to people on Aquidneck Island, stays open
Reduce HEALTH DISPARITIES and improve HEALTH EQUITY so all Rhode Islanders can live full and healthy lives:
- Raise an estimated $203 million in annual revenue to fund healthcare, education, transit, and more by enacting the Revenue for Rhode Islanders' proposal to increase income tax for the top 1% of earners (Alzate H 7313/Murray S 2238)
- Create a fully refundable $650 child tax credit (Tanzi H 8338/Vargas S 2823)
- Improve the state’s Paid Family Leave Act (Giraldo H 7968/Lawson S 2737).
- Increase access and monthly payment amounts for Rhode Island Works (Handy H 7689/Murray S 2828)
- Require an annual equity impact review (Morales H 7236/Mack S 2989) of the Rhode Island state budget for potential disparities in regard to race, gender, and disability