PROVIDENCE — The state Senate approved legislation Thursday intended to protect Rhode Islanders’ access to health insurance in the face of threats to the federal Affordable Care Act.

The legislation was sponsored by Sen. Joshua Miller, D-Cranston, chairman of the Senate Health and Human Services Committee. The House version of the bill was sponsored by Rep. Joseph M. McNamara, D-Warwick,  chairman of the House Health, Education and Welfare Committee. The bill aims to ensure that the standards of the Affordable Care Act remain in effect in Rhode Island, even if the courts or Congress were to eliminate the federal laws that created it.

The sponsors said that the bill (2019-S 0738A) is also intended to provide predictability to insurers, stabilizing the Rhode Island insurance market.

“Whatever may happen at the federal level, we want to do everything we can to help Rhode Islanders remain adequately insured. This bill enacts the Affordable Care Act’s standards of care that in most instances have been in place since 2010 at the state level in case the ACA is overturned or repealed,” Miller said in a statement. “It also tells insurers that, here in Rhode Island, the quality of insurance is not going to change, so they know what benefits and coverage they can offer to policyholders. They have to be able to know the parameters to which they’re going to be held in the near future in order to write policies.”

The bill will now go to the House of Representatives; the companion legislation is 2019-H 5916.

The legislation would enact into state law the current insurance practices that protect consumers under the ACA, such as:

Giving people clearer explanations of their benefits.

Prohibiting annual limits and lifetime dollar caps on coverage for essential benefits.

Requiring that insurers keep their administrative costs in check.

Guaranteeing that dependents up to age 26 can stay on their parents’ plans.

Guaranteeing protections against pre-existing condition exclusions.

Requiring essential benefit coverage that must be included at every tier of coverage (preventive services, maternity, hospital, mental health).

Guaranteeing coverage of preventive services without patient cost-sharing.

Guaranteeing issue and renewal so no one can be denied a policy, even if sick.

Allowing discounts for wellness programs.

Allowing insurance premium rates to vary only by age (not gender or health).

Setting out-of-pocket limits with a process for updating these annually.

On March 25, the Justice Department filed a letter with the 5th U.S. Circuit Court of Appeals changing its position on the ACA.

It previously objected to the law’s provision that prohibits insurers from turning away people with pre-existing conditions, but is now arguing that the entire law should be struck down.

The department urged the court to affirm a U.S. District Court ruling in December that sought to invalidate the entire Obamacare law, saying it “is not urging that any portion of the district court’s judgment be reversed.”

In the lower court case, the issue was whether the ACA could stand without its individual mandate for coverage, which imposed a penalty for taxpayers who did not sign up for health insurance. The Republican tax law that went into effect in 2018 eliminated the penalty.


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