The Rhode Island Senate Committee on Health and Human Services passed three bills out of committee on Thursday night in its first meeting of the year. The bills would extend coverage of telemedicine and provide coverage for it under RI Medicaid and enshrine certain ACA consumer protections and varying health insurance premium rates based on gender.
“Our priority will have bills that are important to address the COVID-19 pandemic,” said Sen. Josh Miller (District 28 – Cranston), committee chair. He continued, “Future meetings will therefore address issues such as nursing home visitation, overdose prevention and access to healthcare in the hardest hit communities.”
While most of the bills passed unanimously, many among the public testifying last night were concerned over language in the Sub A of Senate Bill 4. The bill would extend coverage of telemedicine under Rhode Island Medicaid. Some industry groups from different outpatient specialties were concerned that their own field was left out, as only primary care and behavioral health are specified in the bill. Sen. Miller noted that the reason is that the provider networks for insurers were historically inadequate (pre-COVID) for primary care and behavioral healthcare, and that the reimbursement rates were much lower for the providers than other specialties.
“Already we have the data, both anecdotal and scientifically, on how access to behavioral health and primary care was improved based on telemedicine during the pandemic.” said Miller. He said not having that parity language for the two fields would be a big step back, especially if reimbursement rates for telemedicine were lower than for in person. The bill was introduced by Miller, and cosponsored by Sens. Gayle Goldin (District 3 – Providence), Bridget Valverde (District 35 – EG, NK, SK, and Narragansett), and Maryelln Goodwin (District 1 – Providence).
Senate Bill 5 protects consumer protections as they exist under the Affordable Care Act, laying out a list of essential services that all health insurance must cover if they wish to sell health insurance in Rhode Island. The bill was (again) introduced by Miller himself, with Sens. Ryan Pearson (District 19 -,Cumberland/Lincoln) Valerie Lawson (District 14 – East Providence), Meghan Kallman (District 15 – North Providence/Pawtucket) and Frank Lombardo (District 25 – Johnston) cosponsoring. The list of essential services includes but is not limited to hospitalization, emergency services, prescription drugs, maternity and newborn care, lab services, preventative services, and more. The law is written so if the ACA was to be overturned and no longer be the law of the land, health insurance companies would still be bound by these standards in the Ocean State.
Cori Chandler of the American Cancer Society Cancer Action Network presented concerns in telephonic testimony that the current bill is missing elements they consider critical. She emphasized the importance of prohibition on life and annual limits. Prior to the ACA, insurance companies could limit the number of visits to services that would be covered under insurance plans, or just impose a $2,000 limit on coverage every year.
Senate Bill 3 would prohibit insurance companies from charging different rates for premiums based on gender. The bill has been introduced in the past by Sen. Susan Sosnowski (District 37 – New Shoreham, South Kingstown), and as many testifers noted was a source of gender discrimination. Other cosponsors on the bill include Michael McCaffrey (District 29 – Warwick), Goodwin, Hanna Gallo (District 27 – Cranston/West Warwick), and Walter Felag (District 10 – Bristol, Tiverton, Warren). Laurie-Marie Pisciotta executive director of the RI Mental Health Association noted that males were more at risk for schizophrenia, develop it earlier and live with it longer than their female counterparts but the insurance premium rates remain the same.
HHS is the first committee to meet since the start of the term and the first to meet in a digital format. Only Miller and staff were present in the committee room. Other senators on the committee, including new appointees Sam Bell (District 5 – Providence), Alana DiMario (District 36, – Narragansett and North Kingstown) and Jeanine Calkin (District 30 – Warwick), attended using televisual software and broadcast on Capitol TV. Members of the public who wished to testify could either submit written testimony (of which there were 70 letters), or call into the meeting, giving the usual staid senate committee meeting a talk radio show vibe.
While the bills easily sailed out of committee, the work is far from done. Sen. Miller acknowledged the state Senate was now meeting once a week, down from its usual three times a week in the Great COVID Before Time. He acknowledged the testimony and concerns from the public, and proposed sending the bills out of committee onto the floor, and working out amendments as a committee to be presented when the bills are presented. Currently, according to Miller, the earliest the bills could be passed by a floor vote is a week from Tuesday.
“I would give us like a 91 on both technical and conduct,” said Miller, rating how the new format of the meeting went under the circumstances. “Calls were much better than I imagined they might. “