R.I. Senate overwhelmingly OKs bill to preserve Obamacare protections

June 14--PROVIDENCE, R.I. -- The Senate on Thursday overwhelmingly approved a bill to preserve in state law many of the same benefits and protections for health insurance mandated by the Affordable Care Act.

The bill (S-831 Sub A) -- approved by a vote of 30 to 6 -- aims to protect Rhode Island consumers from changes at the federal level should Congress repeal or weaken the federal law, known as Obamacare.

"[This] tells insurers access to quality insurance is not going to change," Sen. Joshua Miller, D-Cranston, said on the Senate floor before the vote. "The bill would protect Rhode Islanders no matter what policies play out in Washington."

The 72-page "Health Insurance Market Stability and Consumer Protection Act" would require Rhode Island insurers that sell individual and small-group plans to cover Obamacare's "10 essential benefits," such as preventive, mental health and maternity services as well as contraceptives.

Miller's bill also would prohibit any state-based insurer, including those that cover large employers, from imposing annual lifetime limits on those benefits, aimed at ensuring access for seriously ill people. And it would guarantee coverage for dependents on their parents' plan up to age 26.

The bill includes measures to keep insurers' administrative costs in check and requires they provide consumers with a clearer explanation of benefits.

Rhode Island law currently bans exclusions for preexisting conditions, as does the bill.

The state protections would apply to about 95,000 Rhode Islanders who purchase major medical plans directly or through small employers from state-based insurers covered under Obamacare. The state protections would not apply to about 80,000 Rhode Islanders who work for large employers (defined as 51 or more employees) with the exception of the ban on lifetime coverage caps.

The bill's supporters include the Rhode Island Department of Health, the Executive Office of Health & Human Services, HealthSource RI, the Hospital Association of Rhode Island and the Mental Health Association of Rhode Island.

But leaders of business groups and some insurers have raised concerns about what the bill would mean without the funding to support it.

The bill contains no mandate that consumers buy insurance -- a key provision of Obamacare aimed at keeping younger, healthier people from dropping coverage and driving up costs.

Nor does it include subsidies, as in the federal law, to make the plans more affordable.

The bill attempts to address affordability by banning caps on essential-benefits coverage to reduce patients' out-of-pocket costs, and requiring insurers to maintain a 3-to-1 ratio for premium rates based on age. A 64-year-old, for example, could not be charged more than three times the premium rate as a 21-year-old.

Five Republicans and one Democrat voted against the bill: Senate Minority Leader Dennis L. Algiere, R-Westerly; Sen. Marc A. Cote, D-Woonsocket; Sen. Mark W. Gee, R-East Greenwich; Sen. Nicholas D.Kettle, R-Coventry; Sen. Elaine J. Morgan, R-Hopkinton and Sen. Thomas J. Paolino, R-Lincoln.

Rhode Island is one of at least five states -- including New Hampshire, Hawaii, New Jersey and Texas -- that have pending measures aiming to incorporate the federal essential-benefits protections into state law, according to the National Conference of State Legislatures.

larditi@providencejournal.com

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On Twitter: @LynnArditi

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