Rhode Island: State senate votes to lock in nearly all ACA #BlueLegProtections!

Last week I reported that California and New Jersey were pushing through a long list of "Blue Leg" ACA protections at the state level; it turns out that Rhode Island has been quietly pushing through their own suite of ACA protection legislation as well! This is from May 16:

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.

...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.

This list amounts to locking in 7 of the 8 major "Blue Leg Protections" of the ACA (Guaranteed Issue, Community Rating, Essential Health Benefits, No Annual/Lifetime Coverage Limits, Maximum Out of Pocket Expenses, Free Preventative Services and Young Adults on Parents Plan up to 26), along with one of the "Green Leg" protections (replicating the ACA's 80/20 Medical Loss Ratio).

Rhode Island actually already did have weaker versions of a few of these (i.e., under current law young adults can apparently stay on their parents plans until age 25, but only if they're a full-time student and unmarried); in those cases this is just strengthening them.