The "Rhode Island Individual Market Affordability Act of 2025" aims to create a state affordability program to reduce out-of-pocket costs for low- and moderate-income individuals enrolled in health insurance coverage through the Rhode Island health benefits exchange. The bill introduces a new chapter, CHAPTER 157.2, within Title 42 of the General Laws, which outlines definitions, the establishment of the affordability program, and the creation of a dedicated program fund.
The program will provide subsidies and cost-sharing reductions to eligible individuals, addressing the rising costs of healthcare. It authorizes the director of the Rhode Island health benefits exchange to establish the affordability program, which will mitigate the impact of high healthcare costs for low- and middle-income Rhode Islanders. The program will include payments to health insurance carriers to enhance affordability for individuals receiving federal premium tax credits and those above the income limit for such credits.
Additionally, the bill establishes the health insurance individual market affordability account within the general fund to support this initiative. The account will be funded through a portion of the amount collected from healthcare services funding contributions and other sources. The exchange is required to submit an annual report to the general assembly regarding the program and its costs.
The act also creates the Individual Market Affordability Board, composed of various stakeholders, to recommend the distribution of program fund revenues and identify eligible populations for subsidies. The board will consider recommendations from a marketplace coverage affordability work group for the year beginning January 1, 2026.
Furthermore, the bill amends existing laws regarding indirect cost recoveries on restricted receipt accounts, specifying that the health insurance individual market affordability account shall be exempt from indirect cost recovery provisions. The act is set to take effect upon passage.
Statutes affected: 5996: 35-4-27