The "Rhode Island Individual Market Affordability Act of 2025" establishes a state affordability program aimed at reducing out-of-pocket costs for low- and moderate-income individuals enrolled in health insurance coverage through the Rhode Island health benefits exchange. This act creates a new chapter in Title 42 of the General Laws, which includes definitions and a framework for the affordability program, managed by an Individual Market Affordability Board.

The board is responsible for issuing recommendations regarding the specific terms of the affordability programs and will consist of various members, including representatives from health insurance carriers, healthcare providers, advocacy organizations, and consumers. The act emphasizes the importance of diversity in board appointments and mandates that the board meet regularly to fulfill its duties.

A restricted receipt account, known as the Health Insurance Individual Market Affordability Account, is created within the general fund to support the program. The funds will be allocated to enhance health insurance affordability for individuals receiving federal premium tax credits and those above the income limits for such credits. The director of the exchange is authorized to implement affordability programs and direct payments to carriers to improve the affordability of health insurance coverage.

The act also includes provisions for the board to be reimbursed for necessary expenses incurred while performing its duties. It requires the exchange to submit an annual report to the general assembly regarding the program and its costs. The act is designed to improve health insurance affordability for vulnerable populations in Rhode Island and will take effect upon passage.

Statutes affected:
5996: 35-4-27