Rhode Island health insurance

Rhode Island has established a reinsurance program and an individual mandate as of 2020. Due to COVID-19, uninsured residents can enroll in health insurance plans through April 15, 2020.

Health insurance in Rhode Island

This page is dedicated to helping consumers quickly find health insurance resources in the state of Rhode Island. Here, you’ll find information about the many types of health insurance coverage available. You can find the basics of the Rhode Island health insurance marketplace and upcoming open enrollment period; a brief overview of Medicaid expansion in Rhode Island; a quick look at short-term health insurance availability in the state; statistics about state-specific Medicare rules; as well as a collection of health insurance resources for Rhode Island residents.

Rhode Island’s health insurance marketplace

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

Rhode Island is one of the states fighting the hardest to preserve the Affordable Care Act’s gains. See the steps Rhode Island has taken.

Rhode Island utilizes a state-run health insurance marketplace – HealthSource RI – an active purchaser exchange. That means that the marketplace negotiates directly with insurers, and determines which plans will be made available each year.

In most states, enrollments outside of the open enrollment period (ie, during a special enrollment period) must be completed by the 15th of the month in order to have coverage effective the first of the following month. But Rhode Island is one of just two states where the deadline is the 23rd of the month.

Two carriers – Blue Cross Blue Shield of Rhode Island and Neighborhood Health Plan of Rhode Island — offer medical insurance through HealthSource RI. Thanks to the state’s new individual mandate and reinsurance program, the overall proposed rate increase for 2020 was less than 1 percent. And once regulators finished reviewing the filings, the average approved rate change was a decrease of about 0.5 percent

For 2020 coverage, 32,704 people selected private individual marketplace plans through HealthSource RI during open enrollment.

Read more about the Rhode Island health insurance marketplace.

Rhode Island open enrollment period and dates

Open enrollment in Rhode Island for 2020 coverage ended on December 31, 2019, which was an extension of the original deadline. But as a result of the COVID-19 pandemic, HealthSource RI is allowing uninsured residents an opportunity to enroll in health insurance coverage. The special enrollment period runs through April 15, 2020.

Medicaid expansion in Rhode Island

Rhode Island immediately embraced the provision to expand Medicaid coverage under the Affordable Care Act.

Immediately after the Supreme Court ruled in 2012 that Medicaid coverage expansion would be optional for the states, Former Gov. Lincoln Chafee made it clear that Rhode Island would be implementing Medicaid expansion. At the time, Rhode Island estimated that about 40,000 additional people would enroll in Medicaid plans through 2022, with most of them (about 83 percent) being newly-eligible as a result of Medicaid expansion. But the state noted that there was considerable uncertainty in terms of how many people would actually be newly-eligible and newly-enrolled.

As of late 2019, Medicaid enrollment in Rhode Island was 53 percent higher than it had been in 2013, and included more than 100,000 additional enrollees. In that timeframe, the state has seen a 64 percent reduction in the uninsured rate, from 11.6 percent uninsured in 2013 to 4.1 percent uninsured in 2018.

Read more about Medicaid coverage expansion in Rhode Island.

Short-term health insurance in Rhode Island

The sale of short-term health insurance plans is not banned in Rhode Island, but due to its strict regulations, no insurers offer short-term health insurance plans in the state. The state’s restrictions include a mandate that short-term health insurance coverage include essential health benefits, cover pre-existing conditions, and premiums cannot be based on medical history.

No short-term health insurance plans have been approved for sale in the state for several years.

Read more about short-term health insurance plans in Rhode Island.

How has Obamacare helped Rhode Island?

With a state-based health insurance marketplace (HealthSource RI) and Medicaid coverage expansion, Rhode Island has fully embraced the Affordable Care Act. And, the healthcare reform law has been quite effective for the state. Rhode Island has seen the ninth-largest reduction in the percentage of residents without health insurance since 2013 and now has one of the nation’s lowest uninsured rates.

The Rhode Island exchange enrolled about two and a half times as many people in expanded Medicaid coverage than in private plans during the 2014 open enrollment period, so Medicaid expansion has played a key role in reducing the number of uninsured residents in the state.

Rhode Island and Obamacare

In 2010, Rhode Island’s U.S. Senators – Democrats John Reed and Sheldon Whitehouse – both voted yes on the ACA. In the U.S. House, both of the state’s Representatives were also Democrats – Patrick Kennedy and Jim Langevin – and voted yes.

Kennedy has since been replaced by another Democrat, David Cicilline, who is also supportive of the ACA and has stated that “protecting the programs created through the recent health care reform is one of [his] top priorities in congress.” Thus, the entire U.S. congressional delegation from Rhode Island is Democratic and supportive of healthcare reform.

Rhode Island’s state legislature also has a very strong Democratic majority. Former Gov. Lincoln Chaffee, a Democrat, was an ardent supporter of the law, “fully committed to ensuring that Rhode Island is a national leader in implementing health reform …” Chaffee has since been replaced by Gov. Gina Raimondo, a Democrat who took office in 2015 and is strongly invested in healthcare reform.

The state has been fully on-board with ACA implementation from the get-go, opting for a state-run exchange (HealthSource RI) and agreeing to expand Medicaid to cover all of the state’s legal residents with incomes up to 138 percent of poverty.

In late spring 2014, there was some talk in the legislature about switching to a federally-facilitated exchange in order to be more cost-effective, but that ultimately did not happen and the state is still running the exchange.

Medicare coverage and enrollment in Rhode Island

As of February 2020, there were 222,641 Rhode Island residents enrolled in Medicare plans. About 48 percent are enrolled in Medicare Advantage plans, while the rest have Original Medicare.

Read more about Medicare enrollment in Rhode Island.

Health reform legislation in Rhode Island

In 2018 and 2019, Rhode Island enacted legislation to implement a state-based individual mandate starting in 2020, and to create a reinsurance program to stabilize the state’s individual insurance market (the reinsurance program was subsequently approved by the federal government and took effect in 2020).

Here’s a look at additional state-level health reform bills in Rhode Island:

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