Rhode Island Health Insurance

 Rhode Island Health Insurance

● Rhode Island uses a state-run health insurance market, where individuals, families, and small businesses can purchase health coverage.

● Open enrollment in Rhode Island for 2021 coverage is November 1 to December 15, 2020.

● Outside of the open enrollment period, residents can still purchase health insurance if they have a qualifying event.

● Two couriers offer coverage through HealthSource RI.

● Average premiums in the individual RI market have fallen by about half a percentage point for 2020, thanks to reinsurance and an individual mandate. But average rates are rising by more than 4% by 2021.

● More than 34,000 enrolled in 2020 coverage through Rhode island's health insurance market.

● Rhode Island adopted the expansion of the ACA's Medicaid coverage and began enrolling residents in 2013.

● Due to strict state regulations on short-term health insurance, no short-term health insurance plan has been approved for sale in Rhode Island for several years.

● More than 20% of Rhode Island's population is enrolled in Medicare plans.

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

Rhode Island's health insurance marketplace

Rhode Island uses a state-run health insurance market -- Healthsource RI -- that's an active buyer exchange. This means that the market negotiates directly with insurers and determines which plans will be made available each year.

The market/exchange is used by individuals and households who have to buy their own coverage, as well as by small businesses that buy group health coverage for their employees. People who purchase their health cover include the self-employed, pre-roasted pensioners and people employed in a small business that does not offer benefits for the health of employees. Depending on household income, they can also benefit from premium grants and cost-sharing reductions through Healthsource RI, which reduce premium costs and out-of-pocket costs for eligible enrollees.

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

Two health insurance companies - Rhode Island's Blue Cross Blue Shield and Neighborhood Health Plan of Rhode Island - offer medical insurance through Healthsource RI. Thanks to the new individual mandate and the new state reinsurance program, overall premiums fell by about 0.5% for 2020. For 2021, rates will rise by an average of around 4.2%.

For 2020 coverage, 34,643 people selected individual private marketplace plans through Healthsource RI during open enrollment.

Open enrollment period and dates in Rhode Island

The registration open in Rhode Island for 2021 coverage is from November 1, 2020 to December 15, 2020. Last year, for 2020 coverage, Healthsource RI issued an extension until the end of December, giving residents two more weeks to sign up. A similar extension could be issued for 2021 coverage, but for now, Rhode Island residents should plan to enroll, renew their coverage, or make changes to their plan by December 15.

Rhode Island is one of the few states where there is a tax penalty for not having health insurance. The state's individual mandate went into effect in 2020, and the penalty for non-compliance will be assessed on state tax returns in Rhode Island starting in early 2021. The open enrollment period is the only period during the year (unless a person experiences a qualifying event) where residents can enroll in self-purchased health coverage in order to comply with the state's individual mandate.

The enrollment period open from November 1 to December 15 is not applicable to people who have Medicare (which has several enrollment periods open), Medicaid (enrollment is available year-round), or employer-sponsored coverage (each employer sets their own open enrollment program).

Rhode Island Medicaid expansion

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

Soon after the Supreme Court ruled in 2012 that expanding Medicaid coverage would be optional for states, former Governor Lincoln Chafee made it clear that Rhode Island would implement Medicaid expansion, expanding coverage eligibility for all non-elderly adults with family incomes up to 138 percent of the poverty level. 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). just eligible because of Medicaid expansion. But the state noted that there was considerable uncertainty in terms of how many people would actually be barely eligible and newly enrolled.

By mid-2020, Medicaid enrollment in Rhode Island was 58% higher than in 2013 and included more than 110,000 additional enrollees. During this time, the state has seen a 64% reduction in the uninsured rate, from 11.6% uninsured in 2013 to 4.1% uninsured in 2018 and 2019.

Short-term health insurance in Rhode Island

The sale of short-term health insurance plans is not prohibited in Rhode Island, but because of its strict regulations, no insurer offers short-term health insurance plans in the state. The state's restrictions include a mandate that short-term health insurance coverage includes essential health benefits, covers pre-existing conditions, and premiums cannot be based on medical history.

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

How did Obamacare help Rhode Island?

With a state health insurance market (Healthsource RI) and expanding Medicaid coverage, Rhode Island has fully embraced the Affordable Care Act. And the health reform law was quite effective for the state. Rhode Island has seen the biggest reduction in the percentage of residents without health insurance since 2013 and now has one of the lowest uninsured rates in the nation.

The Rhode Island exchange recorded about two and a half times more people in extended Medicaid coverage than private plans during the 2014 open enrollment period, so Medicaid expansion 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 to the ACA. In the U.S. House, both representatives of the state were also Democrats - Patrick Kennedy and Jim Langevin - and voted yes.

Kennedy has since been replaced by another Democrat, David Cicilline, who is also pro-ACA and said that "protecting programs created through recent health care reform is one of his top priorities in Congress." Therefore, the entire delegation of the United States Congress from Rhode Island is democratic and in favor of health care reform.

Rhode Island's state legislature also has a very strong Democratic majority. Former Governor Lincoln Chaffee, a Democrat, was an ardent supporter of the law, "fully committed to ensuring Rhode island is a national leader in the implementation of health care reform..." Chaffee has since been replaced by Governor Gina Raimondo, a Democrat who became suspicious in 2015 and is heavily invested in health care reform.

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

At the end of spring 2014, the legislature talked about moving to a federally facilitated exchange to be more convenient, but in the end that didn't happen and the state is still managing the exchange.

Medicare coverage and enrollment in Rhode Island

Medicare is federally run health coverage for people aged 65 and over and people with long-term disabilities. As of August 2020, there were 224,443 Rhode Island residents enrolled in Medicare plans. About 48% are enrolled in Medicare Advantage plans, while the rest have

Original Medicare. Most Medicare beneficiaries in Rhode Island are eligible for Medicare because of their age, but 17 percent are under 65 and are eligible for Medicare because of a disability.

Rhode Island Health Insurance Resources

● HealthSourceRI : State-run marketplace/exchange in Rhode Island. It provides health insurance options for individuals, families, and small businesses, as well as financial assistance for individuals and families based on family income.

● Rhode Island Health Center Association - Certified navigator and application consultant services to help people sign up for coverage through HealthSourceRI. It can provide assistance with private plan enrollment and Medicaid/CHIP enrollment, as well as information about applicable financial assistance available to offset costs in private plans.

● Rhode Island Office of Healthy Aging, Medicare Counseling — The state health care program for Medicare beneficiaries; you can provide information, assistance and advice regarding registration, eligibility and complaints.

● Medicare Rights Center - A national service that can provide advice, information, and assistance to Medicare beneficiaries and their caregivers.

Rhode Island Health Reform Legislation

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 later approved by the federal government and went into effect in 2020).