Rhode Island House Bill H5499

Rhode Island 2025 Regular Session

• Introduced: 2/13/25
• Refer: 2/13/25

Caption

Seeks to promote increased consumer access to Medicare supplement health insurance policies.

Summary

H5499 amends Rhode Island’s Medicare supplement insurance law to expand access to Medigap coverage and strengthen consumer protections. The bill requires Medicare supplement Plan A policies to be made available to certain applicants under age 65 who qualify for Medicare because of disability or end-stage renal disease, and it bars insurers from using medical underwriting or health-status screening for those eligible applicants. It also creates guaranteed issue rights for standardized Plan A coverage during an annual enrollment period for people enrolled in Medicare Parts A and B, including those in Medicare Advantage who remain enrolled when applying. The bill further directs the health insurance commissioner to adopt and enforce regulations governing Medicare supplement policies, including standards for renewability, eligibility, nonduplication of coverage, benefit limitations, replacement rules, and definitions. It authorizes regulation of premium rates, claims practices, marketing, compensation, reporting, loss-ratio requirements, public access to policy and premium information, and approval of policy forms and premium increases. The measure also requires annual review of premium rates by the Office of the Health Insurance Commissioner and allows administrative penalties for insurer violations. The act would take effect January 1, 2026.

Impact

This bill would amend Chapter 27-18.2 of the Rhode Island General Laws governing Medicare supplement insurance policies. Its practical effect is to broaden guaranteed access to Medigap coverage for certain Medicare beneficiaries, especially people under 65 who qualify through disability or end-stage renal disease, and to limit insurer discretion to deny coverage or vary access based on medical underwriting. It also reinforces OHIC’s regulatory authority over policy standards, pricing oversight, and enforcement, while preserving the attorney general’s authority under other state or federal law.

Sentiment

The available bill materials indicate generally supportive intent, with the stated purpose of promoting increased consumer access to Medicare supplement health insurance policies. No committee transcript or recorded vote is provided, so there is no documented opposition or amendment debate in the supplied materials. Based on the text, the bill appears consumer-protection oriented and aimed at expanding coverage options rather than restricting them.

Contention

The main policy tension in the bill is between consumer access and insurer underwriting/pricing flexibility. Insurers may view the guaranteed-issue and community-rating style requirements, along with limits on medical underwriting and annual rate review, as constraints on their ability to manage risk and set premiums. On the other hand, supporters would likely emphasize equitable access for disabled and ESRD Medicare beneficiaries and stronger protections against denial of coverage or discriminatory pricing. No specific stakeholder objections are included in the provided record.