Rhode Island Attorney General Proposes Health Care Overhaul With Public Insurance Option
Rhode Island Attorney General Peter Neronha unveiled a health care overhaul proposal at an October 29 press conference in Providence, in Providence County, calling for a reorganization of the state Department of Health, the state's administration of Medicaid and the agency that oversees both. Neronha, who is not seeking reelection this year because he has reached his term limit, characterized the industry and the state government structure that regulates it as overburdened and ineffective.
The proposal presents data painting a difficult picture of Rhode Island's health system: many residents are without primary care providers, lack insurance or cannot afford out-of-pocket costs even if covered; hospital operations are financially unstable, premium hikes are outpacing wage increases, emergency rooms are overrun and primary care appointments face long delays. Without urgent reform, the proposal reads, these pressures will deepen systemic failures, while federal budget cuts to Medicaid and instability in private insurance markets intensify the need for comprehensive structural reform.
On reorganization, the plan would restructure the Rhode Island Executive Office of Health and Human Services (EOHHS), established in 2005 as an umbrella agency overseeing the state health department, the Office of the Health Insurance Commissioner (OHIC) and the state's annual administration of roughly $3 billion in Medicaid, among other functions. Under the plan, health care regulation would be centralized under two reconstituted Cabinet-level agencies: a Health Administration and Financing Agency, encompassing the health department, OHIC, Medicaid, HealthSource RI and the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals; and a Human Services Agency, covering the Department of Human Services, the Office of Healthy Aging, the Department of Children, Youth and Families and the Office of Veteran Services.
The proposal would also create the Office of Health Policy and Progress as a new, independent agency to enhance health data analysis and health policy development, setting long-term policies to put the state's health care system on a path to sustainability. The proposal says Rhode Island's health agencies are fragmented and under-resourced, and that hospitals, nursing homes and other facilities have historically changed hands with minimal scrutiny, resulting in repeated cycles of mismanagement and underinvestment.
Another core element is a public health insurance option, a state-run plan that Rhode Islanders and employers could choose to enroll in, collecting premiums, paying providers and using state subsidies to make coverage more affordable. The proposal estimates it would require close to $400 million in annual state funding, about 3 percent of total health care expenditures per year in Rhode Island. Citing a report by the Center for Advancing Health Policy through Research at Brown University's School of Public Health, the proposal says a public option could reduce premiums by 80 percent and expand coverage to more than 133,000 Rhode Islanders. Neronha said federal changes, including the One Big Beautiful Bill Act and the expiration of enhanced Affordable Care Act premium tax credits, are expected to result in about 52,000 Rhode Islanders losing coverage.
Neronha said he does not expect the plan to pass immediately; the overhaul would be packaged into legislative bills for consideration by the Rhode Island General Assembly in 2027. In his eight-year tenure, he greatly expanded his office's role in health care regulation, denying the proposed merger between Lifespan and Care New England in 2022 and helping broker the Centurion Foundation's acquisition of Our Lady of Fatima Hospital and Roger Williams Medical Center, completed in March, which placed the two ailing hospitals into new nonprofit ownership.
Source: GSM · USA (original Chinese edition)
Photo: 位于普罗维登斯市的罗得岛州议会大厦（资料图）。CC BY-SA 4.0，经 Wikimedia Commons。 / The Rhode Island State House in Providence (file photo). CC BY-SA 4.0, via Wikimedia Commons.
