AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- RHODE ISLAND PROTECT OUR HEALTHCARE ACT OF 2026 (Creates a publicly funded program for uninsured individuals requiring on an appropriation of $53,200,000 for fiscal year 2027 and an appropriation of 109,600,000 for fiscal year 2028 and every fiscal year thereafter.)

H8137

2026 -- H 8137
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LC005206
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
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A N A C T
RELATING TO STATE AFFAIRS AND GOVERNMENT -- RHODE ISLAND PROTECT
OUR HEALTHCARE ACT OF 2026

Introduced By:
Representatives Donovan, Tanzi, Alzate, McGaw, Boylan, Speakman,
Casimiro, Cruz, Diaz, and Furtado

Date Introduced:
February 27, 2026

Referred To:
House Corporations
It is enacted by the General Assembly as follows:
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SECTION 1. Title 42 of the General Laws entitled "STATE AFFAIRS AND
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GOVERNMENT" is hereby amended by adding thereto the following chapter:
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CHAPTER 7.5
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RHODE ISLAND PROTECT OUR HEALTHCARE ACT OF 2026
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42-7.5-1. Short title and purpose.

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(a) This chapter shall be known and may be cited as the “Rhode Island Protect Our
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Healthcare Act of 2026.”
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(b) The purpose of this chapter is to create a state program to provide healthcare services
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to individuals who cannot obtain affordable health insurance coverage and who lack the means to
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pay for their own healthcare services.
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42-7.5-2. Definitions.

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As used in this chapter:
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(1) “Advisory committee” means the uninsured care advisory committee established
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pursuant to § 42-7.5-4.
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(2) “Board” means the uninsured care board established pursuant to § 42-7.5-4.
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(3) “Community health centers” shall have the meaning provided in § 40-8-26.
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(4) “Individual” means any person who is a resident of the State of Rhode Island.
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(5) “Participating hospital” shall have the meaning provided in § 40-8.3-2.

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(6) “Secretary” means the secretary of the executive office of health and human services.
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42-7.5-3. Program fund.

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(a) There shall be established a state general fund appropriation to fund the activities
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described in this chapter, and to be allocated by the board pursuant to the procedure described in §
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42-7.5-5.
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(b) For the fiscal year beginning July 1, 2026 and ending June 30, 2027, there shall be
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appropriated from the general fund fifty-three million two hundred thousand dollars ($53,200,000)
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for the administration of the program established pursuant to this chapter.
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(c) For any fiscal year beginning on or after July 1, 2027, there shall be appropriated from
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the general fund one hundred nine million six hundred thousand dollars ($109,600,000) for the
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administration of the program established pursuant to this chapter.
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42-7.5-4. Uninsured care board and advisory committee.

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(a) There shall be established a seven (7) member Rhode Island uninsured care board,
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which shall include the following members:
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(1) The secretary of the executive office of health and human services, who shall serve as
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chair of the board;
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(2) The commissioner of the office of the health insurance commissioner;
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(3) The director of the department of health;
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(4) The Medicaid director;
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(5) One person to be appointed by the governor with the advice and consent of the senate;
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(6) One person to be appointed by the president of the senate; and
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(7) One person to be appointed by the speaker of the house of representatives.
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(b) There shall be established the uninsured care board advisory committee, which shall
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include at least the following nine (9) members, to be appointed by the secretary of the executive
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office of health and human services in consultation with the other members of the board:
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(1) A representative of community health centers;
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(2) A representative of participating hospitals;
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(3) A representative of a free clinic;
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(4) A representative of a primary care provider not employed by a community health center
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or a practice owned by a hospital system;
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(5) A behavioral healthcare provider;
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(6) Two (2) additional healthcare providers, each of whom practices in a different specialty
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than the other;
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(7) A representative of a healthcare advocacy organization;

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(8) A consumer of healthcare who is not a representative or an employee of any provider
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of healthcare or an insurance carrier; and
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(9) Any other persons appointed by the secretary to create a board with a comprehensive
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composition to include a range and diversity of skills, backgrounds, and stakeholder perspectives.
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(c) The board shall undertake a review of existing programs that serve uninsured
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individuals including, but not limited to, identifying:
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(1) Programs that provide services to uninsured individuals;
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(2) The scope of services provided by the aforesaid programs;
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(3) Whether the programs provide services to uninsured individuals only;
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(4) The qualifications associated with those programs used to condition participation;
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(5) The methodology the programs use to provide funding to participating providers, if
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applicable; and
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(6) The size of the programs including, but not limited to:
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(i) The number of individuals served;
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(ii) The number of services provided;
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(iii) The cost of the program; and
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(iv) Any other metrics fundamental to explaining the capacity of the program.
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(d) The board shall, on or before February 1, 2027, provide a report to the general assembly
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detailing the information provided for in subsection (c) of this section.
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(e) The board shall determine the appropriate allocation of funds to be distributed under §
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42-7.5-5, the design and implementation of the program created by § 42-7.5-6, the process by which
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the program shall be evaluated, and all reporting on the design, efficacy, and impact of the program.
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(1) The board shall make such determinations and exercise its authority with consideration
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to the recommendations made by the advisory committee.
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(2) The board shall provide appropriate opportunities for stakeholders and the public to
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consult in its deliberations, pursuant to the specifications of § 42-7.5-7.
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42-7.5-5. Allocation of program fund.

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(a) The board may allocate funds appropriated under this chapter to advance programs that
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will traceably provide expanded access to care for uninsured individuals utilizing appropriated
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funding. The board may:
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(1) Provide additional distributions of funds to participating hospitals in accordance with
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§ 40-8.3-3;
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(2) Provide additional distributions of funds to community health centers in accordance
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with § 40-8-26;

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(3) Provide additional distributions of funds to the Rhode Island Free Clinic, Clínica
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Esperanza, or any other clinic that provides healthcare services free of charge to individuals;
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(4) Provide funding for the uninsured health access program established pursuant to § 42-
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7.5-6; and
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(5) Provide funding for the operation of the board and the advisory committee.
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(b) If any funds allocated to any of the activities provided pursuant to subsection (a) of this
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section remain unexhausted at the end of a state fiscal year, they shall not be returned to the general
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fund and the board may reallocate them to the same activity or another activity for a subsequent
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fiscal year.
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42-7.5-6. Uninsured health access program.

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(a) The Rhode Island uninsured health access program (“program”) is hereby established:
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(1) To support individuals who are uninsured;
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(2) To support healthcare providers to provide access to a spectrum of healthcare services
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not otherwise available to individuals without regard to ability to pay; and
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(3) That provides payment directly to participating healthcare providers, on behalf of
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individuals, in correspondence to specific qualifying services rendered by those providers and/or
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contingent upon the providers’ adherence to access standards established by the board.
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(b) The program shall serve as the payer of last resort for any services rendered to uninsured
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individuals, up to the amount allocated by the board under § 42-7.5-5(a)(3).
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(c) The board may establish:
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(1) The qualifications for a provider to participate in the program;
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(2) The services covered by the program;
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(3) The qualifications for individuals to participate in the program including, but not
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limited to, income or asset limits, and/or the process by which participating providers may set
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guidelines for patient participation; provided that, such guidelines shall be reviewed and approved
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by the board;
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(4) The requirements related to the expanded care to be offered by participating providers
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to uninsured patients in exchange for program funding;
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(5) The screening to be completed by providers for forms of health insurance coverage that
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may be available to individuals supported by the program;
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(6) The process and methodology by which funding is provided to providers under the
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program;
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(7) The process by which providers may confirm the continued availability of funding in
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advance of providing services under this program;

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(8) Any sliding scale or other cost sharing associated with particular services covered by
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the program;
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(9) Any requirements related to prerequisite authorizations or other guidelines necessary
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for specific services to be covered by the program; and
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(10) Any reporting or data submission requirements for participating providers.
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(d) In making its determinations under subsection (c) of this section, the board shall
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prioritize consideration of:
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(1) The recommendations of the advisory committee;
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(2) Aligning the program with other programs that provide care to uninsured individuals
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including, but not limited to, the Breast and Cervical Cancer Treatment Program, Mobile Response
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and Stabilization Services, Emergency Medicaid, hospital uncompensated care or charity care
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programs, sliding scale services provided at community health centers, and services provided by
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free clinics;
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(3) Aligning the program with other statewide initiatives relating to healthcare delivery
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system transformation including, but not limited to, the Rural Health Transformation Program;
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(4) Maintaining as broad a variety of types of healthcare services and providers as possible
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including, but not limited to:
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(i) Primary care services including, but not limited to, services available from providers
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other than free clinics or community health centers;
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(ii) Inpatient and outpatient services;
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(iii) Mental health and substance use disorder services;
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(iv) Specialty care services;
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(v) Preventive services;
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(vi) Imaging and lab services;
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(vii) Dental services; and
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(viii) Prescription drugs.
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(e) The board shall ensure that participating providers who receive funding from the
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program provide bona fide and traceable access to healthcare services for qualified uninsured
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patients including, but not limited to, the ability to make appointments and schedule non-emergency
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or post-acute services, and ensure that funds from the program are not used solely to cover
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participating providers’ existing losses related to existing uncompensated care already provided.
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(f) The board may engage in procurement or other processes to identify and contract with
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participating providers, and may utilize methodologies to maximize the availability of federal
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matching funds or other funds to help support the program.

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42-7.5-7. Rules and regulations.

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(a) The secretary of the executive office of health and human services, in consultation with
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the board, may promulgate rules and regulations as necessary to carry out and implement the
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purposes of this chapter.
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(b) Chapter 35 of title 42, (“administrative procedures”) shall apply for any rules or
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regulations established or issued by the board pursuant to this chapter, except for the first
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implementation year of the program established under this chapter.
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(c) For the first implementation year, the board shall provide opportunities for stakeholders
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and the public to provide input. This shall include, but is not limited to:
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(1) A duly noticed public meeting with advice from the advisory committee established by
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§ 42-7.5-4;
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(2) A thirty (30) day public comment period; and
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(3) Presentation by the board to the public of accompanying explanatory documentation
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outlining any proposed regulatory adoption, any significant changes thereto, and the rationale for
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those decisions.
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42-7.5-8. Construction.

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This chapter shall not be construed to create an entitlement, medical assistance, or a public
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assistance program of any kind.
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42-7.5-9. Severability.

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The provisions of this chapter are severable, and if any provision hereof shall be held
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invalid in any circumstances, any invalidity shall not affect any other provisions or circumstances.
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SECTION 2. This act shall take effect upon passage.
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO STATE AFFAIRS AND GOVERNMENT -- RHODE ISLAND PROTECT
OUR HEALTHCARE ACT OF 2026
***
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This act would create a publicly funded program for uninsured individuals requiring an
2
appropriation of fifty-three million two hundred thousand dollars ($53,200,000) for fiscal year 2027
3
and an appropriation of one hundred nine million, six hundred thousand dollars ($109,600,000) for
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fiscal year 2028 and every fiscal year thereafter.
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This act would take effect upon passage.
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