Availability of short-term health insurance in Rhode Island

No. Rhode Island has very strict regulations, and the RI Office of the Health Insurance Commissioner has confirmed that no insurers offer short-term plans in the state.

Short-term health insurance in Rhode Island is not banned, but the state’s regulations are strict enough that no insurers choose to offer plans in the state. The Rhode Island Office of the Health Insurance Commissioner (OHIC) has long enforced regulations requiring all state-regulated health insurance plans sold in Rhode Island — including short-term plans — to follow various state rules.

Short-term health insurance in Rhode Island must cover all essential health benefits and state-mandated benefits, and must maintain a medical loss ratio of 80% (this is the requirement that applies nationwide to ACA-compliant individual market plans, but short-term health plans in most states tend to have much lower medical loss ratios). Insurance policies in Rhode Island are also required to provide coverage for pre-existing conditions and cannot adjust premiums based on an applicant’s medical history. Complying with these short-term health insurance rules is too onerous for most short-term insurers, and would result in much higher premiums than short-term plans usually have. As a result of Rhode Island’s rules, there are no insurers offering short-term coverage in the state.

The Rhode Island Health Insurance Commissioner’s Office confirmed that there used to be short-term insurance available in the state, but that they have not approved any for sale in the last several years.

Legislation (S2931) was considered in 2018 in an effort to codify and strengthen the state’s regulations for short-term plans into law. It passed in the Senate but not in the House. However, the Insurance Commissioner’s Office noted that nothing would change as a result of that bill not being enacted. The state continues to require all plans to cover state-mandated benefits and cover pre-existing conditions. So the type of short-term plans that are sold in most states are not approved for sale in Rhode Island.

The Trump Administration’s rules for short-term plans, which took effect in late 2018 and were roundly criticized by Rhode Island’s then-Governor Gina Raimondo, are clear in noting that states may continue to impose tighter regulations than the new federal rules, and Rhode Island has continued to do so.

Since 2020, Rhode Island has required residents to maintain health insurance coverage. The Rhode Island statute clarifies that residents must have minimum essential coverage, which is defined the same way it is under the Affordable Care Act. Short-term health insurance is not considered minimum essential coverage, so it would not meet the state’s requirement even if such plans were available in Rhode Island.

Rhode Island residents in need of healthcare coverage should check to see if they can enroll in an ACA-compliant major medical plan, which can be obtained through HealthSource RI, the state’s health insurance exchange (Marketplace), or directly from an insurance company (but subsidies are only available through HealthSource RI, and most people are eligible for subsidies).

In either case, ACA-compliant major medical coverage can only be obtained during open enrollment (November 1 through January 31 in Rhode Island), or during a special enrollment period. There are a variety of qualifying life events that will trigger a special enrollment period allowing you to purchase a plan through the health insurance marketplace in Rhode Island (or directly from an insurer, but that’s only recommended if you’re certain that you won’t qualify for financial assistance, which is only available through the marketplace).

These plans are purchased on a month-to-month basis, so you can enroll in a plan even if you only need coverage for a few months before another policy — like Medicare or an employer’s plan — takes effect. And premium subsidies are available based on household income; as of 2023, 84% of the people enrolled in private health insurance policies through Health Source RI were receiving premium subsidies that reduced their monthly premium costs.

Based on your income you may also qualify for health insurance in Rhode Island under expanded Medicaid coverage. When the Affordable Care Act was enacted in 2010, Medicaid expansion was a cornerstone of lawmakers’ efforts to expand realistic access to healthcare to as many people as possible.

If you have a household income up to 138% of the poverty level, you should be able to enroll in Medicaid (note that the eligibility rules are different for people who are also eligible for Medicare, age 65 or older, or disabled, and Medicaid is available at higher income levels for children and pregnant women).

Learn more about Rhode Island Medicaid.

Yes. Since 2020, Rhode Island residents have been required by law to have qualifying health insurance coverage or to pay a penalty when filing a state tax return.

Short-term health plans are not available in Rhode Island. But even if they were, they would not fulfill the state’s requirement to have qualifying health insurance coverage.

Consumers in Rhode Island can buy ACA-compliant health insurance through the state’s marketplace, HealthSource RI.  Two carriers offer coverage through the exchange in 2023, and both will continue to do so in 2024.

Rhode Island residents may also be eligible for Medicaid coverage.