Chapter 04-587

2004 -- H 7713 AS AMENDED

Enacted 07/31/04

A N A C T

RELATING TO THE HEALTH CARE FOR FAMILIES ACT

Introduced By: Representatives Dennigan, Malik, Anguilla, and Almeida

Date Introduced: February 11, 2004

It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 40-8.4 of the General Laws entitled "Health Care For Families" is

hereby amended by adding thereto the following section:

40-8.4-16. Pilot program for the uninsured - Legislative findings. – (a) The general

assembly hereby finds and declares that:

(1) Although Rhode Island has one of the highest rates of health insurance coverage in

the nation, gaps in coverage remain and the rate of coverage dropped significantly during the past

year; and

(2) From 2001-2002, the state's uninsured rate for working age adults went from eight

percent (8%) to eleven percent (11%), one of eighteen (18) states in the country with a significant

increase; and

(3) Significant health insurance premium rate increases over the past two (2) years

especially for small businesses and the self-insured are contributing to an increase in the rate of

the uninsured; and

(4) The largest segment of uninsured Rhode Island residents are adults with low incomes

many of whom are employed; and

(5) Individuals without health coverage often resort to expensive emergency room care

that ultimately drives up the overall cost of care for everyone and adds to the state's

uncompensated care burden; and

(6) Rhode Island residents use of the emergency room services is greater than that of the

nation; and

(7) The Institute of Medicine defines primary care as the provision of integrated,

accessible health care services by clinicians who are accountable for addressing a large majority

of personal health care needs, developing a sustained partnership with patients, and practicing in

the context of family and community; and

(8) Access to primary health care should be available to every resident of the state

regardless of income and whether or not they have access to health insurance.

     SECTION 2. Chapter 40-8.4 of the General Laws entitled "Health Care For Families" is

hereby amended by adding thereto the following section:

40-8.4-17. Pilot primary care program established. – To increase primary care access

for those state residents who do not have access to health insurance coverage or who are unable to

afford health insurance coverage, the director of the state department of human services in

collaboration with the director of the department of health shall develop a plan for a pilot primary

care program for uninsured residents of the state. The pilot program may include enrollee

premiums and co-insurance payments that are income-based with premiums and/or co-insurance

subsidized by the state. The pilot program may also include catastrophic or reinsurance coverage

provided under the auspices of the state. In designing the pilot program, the director may

consider a variety of service delivery and financing models including capitation payments to

private physicians, a buy-in program under RIte Care and coverage arrangements purchased from

qualified community health centers. In developing the pilot program the director may seek

available federal grant monies, including Medicaid, and private foundation grants. The director

shall submit the plan for the pilot primary care program to the governor, the speaker of the house,

the president of the senate, the majority leaders of the house and senate and the chairpersons of

the house and senate finance committees by January 15, 2005. The plan shall include: eligibility

criteria for participation in the pilot program, the scope of services to be offered, the geographic

area and population to be served, and cost estimates to implement the program.

     SECTION 3. This act shall take effect upon passage.

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LC02142

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