Rhode Island House Bill H5996

Rhode Island 2025 Regular Session

• Introduced: 2/28/25
• Refer: 2/28/25

Caption

Creates the Rhode Island Individual Market Affordability Act of 2024 to help reduce out-of-pocket costs for low- and moderate-income consumers enrolled in the health insurance coverage through the Rhode Island health benefits exchange.

Summary

H5996 creates the Rhode Island Individual Market Affordability Act of 2025, a new state program intended to lower the cost of health insurance for people buying coverage through the Rhode Island health benefits exchange. The bill authorizes the exchange director to establish affordability programs that can provide supplemental state premium tax credits, additional subsidies for people above the federal premium tax credit income limit, and cost-sharing reductions for eligible enrollees. It also directs state officials to seek and coordinate federal or other outside funding, including through existing Medicaid and state innovation waiver authorities, to support the program. The bill sets up a restricted receipt account called the Health Insurance Individual Market Affordability Account and requires that certain amounts collected under the healthcare services funding contribution law be deposited there beginning July 1, 2025. For 2026, the bill requires the program to be funded at no less than $20 million in one scenario and no less than $40 million in another, depending on the generosity of federal premium tax credits, with later funding levels to be guided by a new board and annual reporting. The bill also exempts the new account from indirect cost recovery and amends existing statutes governing the healthcare services funding contribution so that the new affordability account becomes one of the designated uses of those insurer payments.

Impact

The bill would add a new chapter to Title 42 governing state health insurance policy and would amend the state’s restricted receipt account law and the Healthcare Services Funding Plan Act. In practice, it redirects a portion of insurer contribution revenue into a dedicated affordability account, authorizes the exchange to use those funds for premium assistance and cost-sharing subsidies, and creates a new governance structure to recommend program design and funding levels. It also requires the executive branch to pursue federal waiver or plan amendments if needed to maximize available funding, while making clear that the state is not obligated to use general revenue appropriations for the program.

Sentiment

Based on the bill text and the absence of recorded committee testimony or votes in the provided materials, the overall sentiment appears supportive of expanding health coverage affordability for low- and moderate-income Rhode Islanders. The bill’s findings and structure emphasize consumer relief, market stability, and use of existing funding streams rather than new general revenue spending. The inclusion of detailed funding floors, reporting requirements, and a stakeholder board suggests an effort to build a policy framework that can attract broad support from health policy advocates and fiscal planners alike.

Contention

The main points of potential contention are likely to be funding source, cost, and governance. The bill relies on insurer-related healthcare services funding contributions and redirects money into a new restricted account, which could draw concern from insurers, employers, or other payers about added costs or the use of assessment revenue. Another possible issue is the size and rigidity of the required funding levels for 2026, especially if federal premium tax credits change, as well as the bill’s reliance on a board with representatives from carriers, hospitals, providers, businesses, advocates, and consumers to shape program details. There may also be debate over whether the state should commit to this level of subsidy support without using general revenues.