The State of Health Insurance in Rhode Island: How to get yourself insured in a gig economy

Rhode Island did health insurance right in 2019, but in 2020 it’s going to need fine-tuning. According to Megan Hall, a representative from HealthSource RI, “For health insurance, Rhode Island has an insured rate of 96%.” HealthSource RI is a state government agency that helps Rhode Islanders find insurance. According to a survey conducted by them in 2019, more than $8 million was given in financial assistance and more than 1 million people received health insurance for the first time. Rhode Island also has the third least-expensive benchmark plan (the second-lowest cost silver tier plan through the insurance exchange) in the US, and has a bilingual portal to make getting and comparing health insurance plans a cinch. Starting in 2020, those Rhode Islanders who aren’t insured can be charged a tax penalty. Compared to the national average of 8.5% uninsured, Rhode Island is a national leader. 

Nationally, health insurance costs will continue to rise going into the new decade. As found by HealthSource RI, the price of premiums in Rhode Island have gone up 26.4% over the past two years, but 81% of people who got their plans through HealthSource RI received financial help from the government in 2019. Many Rhode Islanders don’t feel the full blow of the increase because they receive tax credits and cost-sharing reductions.

The state is continuing to provide this financial assistance. For those who participated in HealthSource RI’s open enrollment (Nov to Dec 2019), it’s likely that households of someone with an income below $47,000 will receive tax credits for their medical expenses in 2020. Those who went through HealthSource RI’s 2019 open enrollment and qualified for cost-sharing reductions will basically receive discounts on visits to the doctor and other medical needs if they have a silver insurance plan and show their card. In short, insurance in Rhode Island makes strides to make getting insured affordable.

For many Rhode Islanders, finding and using tax credits and cost-sharing reductions was an easy process, thanks to HealthSource RI. “HealthSource RI is a portal to connect you to free or low-cost health insurance,” says Hall. It’s the only place where people can get tax credits and cost-sharing reductions for their plans (if eligible). For example, a person making less than $47,000 can apply for a Blue Cross plan through HealthSource RI and get tax credits, but cannot get tax credits if they get the plan straight from the insurance company.

Buying insurance can be a tricky, technical process, especially for those not acquainted with terms like maximum-out-of-pocket-cost, premiums and deductibles. It’s important to know these terms because a plan might have a low monthly fee (premium) but a high deductible — the amount people pay before their insurance kicks in. If they have a health problem or chronic condition, they probably want a plan with a higher premium but a lower deductible.  

Come 2020 tax time, independent contractors and others with shifting incomes might run into some trouble. If people make more than they stated in the health insurance application and used their tax credits, they’ll owe the government money; fortunately, the reverse is also true. This is why it is important to report changes in income to Healthsource RI as soon as possible and if you don’t know your income, it might be best to set some cash aside for tax time.

Perhaps the biggest source of confusion for Rhode Islanders is whether they’ll have to pay a penalty for not having health insurance. The answer is: there is a fee for not being insured in 2020 if one doesn’t qualify for an exemption. In 2017, Trump got rid of the fee in Affordable Care Act by making it $0. However, in July 2019, Rhode Island brought the fee back; it will affect those who are uninsured in 2020.  

The biggest source of confusion for the state has been finding those who are uninsured and letting them know the fee is back. Due to confidentiality rules, the department of taxation cannot share these names and addresses with Healthsource RI.  Thus Healthsource RI has been partnering with local organizations to give workshops on health insurance and help people enroll, and also has been holding enrollment fairs. 

One trend speaks to the overall reason for being insured — its uptick has lead to more people with mental health conditions getting access to care. Health insurance is part of a neglected form of healthcare: preventative care. For all the creatives out there, it’s important to engage in preventative practices, such as regular doctor visits and building a support network. A person who understands the stress and demands of being a creative and its health toll is Don “DC” Culpa of Tune In and Tune Up, a volunteer organization whose mission is to encourage health awareness and preventive health for musicians and music lovers. “We’re very focused on preventive health … Our organization was founded because we saw many musicians suffering from health problems and deaths of musicians in their 40s, 50s, and 60s.”