Maintaining Low Premiums and Protecting the Affordable Care Act in Rhode Island

WHEREAS, Rhode Island bas fully embraced the Affordable Care Act ("ACA"), and now has the fourth highest rate of insurance coverage in the nation, at over 95%;

WHEREAS, all Rhode Islanders, regardless of any preexisting conditions they may have, deserve access to quality and affordable healthcare;

WHEREAS, Rhode Islanders should never be subjected to "lifetime maximum" coverage limits, just because they have battled serious illnesses such as cancer;

WHEREAS, Rhode Island's state based marketplace, HealthSource RI ("HSRI"), has created a competitive marketplace, offering the lowest cost benchmark plan1 nationwide in 2018, and resulting in two rate decreases from 2015 to 2018;

WHEREAS, Rhode Island has established the Office of the Health Insurance Commissioner's ("OHIC") strong role in rate review of premiums and consumer protections in health insurance;

WHEREAS, OHIC has worked hard to limit rate increases from insurance companies, saving Rhode Islanders almost $22 million this year alone. Since 2012, OHIC has saved consumers over $250 million by approving lower rates than requested;

WHEREAS, I recently signed into law authority to apply for a waiver to establish a reinsurance program that will keep premiums on the individual market low by protecting Rhode Island's market from the disruptive policies coming out of Washington;

WHEREAS, the Trump Administration's actions threaten to reverse this progress and destabilize the group and individual insurance markets;

WHEREAS, those actions have included defunding federal payments for lower income Rhode Islanders on HSRI, repealing the ACA penalties for failing to have health insurance, and proposing expansion of the sale of short-term and association health plans that may not cover pre-existing conditions or critical services such as maternity care or mental health counseling;

WHEREAS, the Trump Administration actions are predicted to result in: an unbalanced risk pool, loss of coverage, and erosion of key consumer protections and essential benefits, and could result in an estimated 17,000 fewer Rhode Islanders enrolled on the individual market, which, in turn, would result in rising premiums for the remaining insured persons; and

WHEREAS, 59% percent of Rhode Islanders enrolled in the individual market benefit from federal assistance to make their insurance affordable, and 41 % are unsubsidized with no mechanism in place to insulate them from bearing the full effect of rate increases.

NOW, THEREFORE, I, Gina M. Raimondo, by virtue of the authority vested in me as Governor of the State of Rhode Island and Providence Plantations, do hereby order and direct the following:

1. The State of Rhode Island shall remain dedicated to the principles of the ACA, working tirelessly to ensure access to affordable and quality healthcare for all Rhode Islanders;
   
    
2. State agencies, including the Executive Office of Health and Human Services ("EOHHS"), OHIC, and HSRI, shall take all necessary actions to protect access to affordable, quality healthcare;
   
    
3. The State shall seek to codify and strengthen consumer protections, including for preexisting conditions, dependents up to age 26, and essential health benefits like prescription drug and maternity coverage into state law;
   
    
4. The State shall seek Federal approval to establish a reinsurance program for the Rhode Island individual market, ·with the objectives of maintaining an attractive market for insurers and keeping premiums low;
   
    
5. OHIC shall aggressively guard against health plans that discriminate based on pre-existing conditions, that do not cover the ACA essential health benefits, and that do not otherwise include standard protections for Rhode Island consumers; and
   
    
6. HSRI shall take all efforts to ensure all Rhode Islanders are informed about the upcoming HSRI open enrollment period and are educated about the best option for their families.

This Executive Order shall take effect immediately.

So Ordered,

Gina M. Raimondo

Governor