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HB 7323

AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

2026 Regular Session Introduced by Karen Alzate and 9 co-sponsors

Requires broad, fully covered (no cost-sharing) coverage of FDA-approved prescription and OTC contraceptives, related services, and supplies for RI insureds and dependents.

05/05/2026 Committee recommended measure be held for further study
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Bill Summary · HB 7323

Summary of HB 7323 (Rhode Island, 2026) — AN ACT RELATING TO INSURANCE — ACCIDENT AND SICKNESS INSURANCE POLICIES

Date Introduced: January 23, 2026
Referred to: House Finance
Status: Scheduled for hearing/consideration (as of May 1, 2026)
Sponsors: Representatives Alzate, Fogarty, Donovan, Spears, Carson, J. Lombardi, Diaz, Cotter, Cruz, Kislak; with Karen Alzate as a co-sponsor

1) Purpose and Intent

  • The bill requires broad coverage for FDA-approved prescription contraceptive drugs and devices under several Rhode Island health insurance statutory titles, expanding access to contraception for insured individuals, their spouses/domestic partners, and dependents.
  • It aims to ensure contraceptive coverage is comprehensive, readily accessible at the point of sale, and free of most cost-sharing, with limited exceptions for religious employers.
  • The act also adds enforcement, monitoring, and public reporting provisions to ensure compliance by insurers and health service organizations.

2) Key Provisions and Changes

The bill amends multiple chapters to extend contraceptive coverage requirements:

  • Coverage Required (across multiple policy types and entities):

    • FDA-approved prescription contraceptive drugs and devices (including all products with a therapeutic equivalent).
    • Over-the-counter (OTC) contraceptives: no prescription required to trigger coverage; coverage at in-network pharmacies without cost-sharing or medical management restrictions.
    • Voluntary sterilization procedures.
    • Clinical services related to contraception (consultations, examinations, procedures, device insertion, ultrasound, anesthesia, education, referrals, counseling).
    • Follow-up services (management of side effects, adherence counseling, device insertion/removal).

  • Cost-Sharing Provisions:

    • No deductibles, coinsurance, copayments, or other cost-sharing for the contraceptive coverage described.
    • For high-deductible health plans with HSAs, cost-sharing must be set at the minimum level to preserve tax-advantaged use of HSAs.

  • Supply and Access:

    • No utilization controls or medical management limiting supply, with a 12-month supply rule (up to 365 days can be dispensed at once or across the year, per prescriber’s discretion).

  • Non-Discrimination and Parity:

    • Benefits must be the same for enrollees’ spouses, domestic partners, and dependents.

  • Religious Employer Exemption:

    • Insurance plans issued to religious employers may exclude coverage for contraception that conflicts with bona fide religious tenets.
    • The exemption does not apply to contraception necessary for non-contraceptive medical purposes (e.g., reducing ovarian cancer risk, menopausal symptoms).
    • Religious employers must provide written notice to enrollees listing covered vs. non-covered contraceptive services.

  • Regulatory Oversight and Rulemaking:

    • The Rhode Island Insurance Commissioner (and analogous bodies for various plan types) must monitor compliance, conduct random plan reviews, and issue annual public reports.
    • Stakeholder engagement is required prior to adopting rules, including input from consumer representatives, youth, low-income communities, and communities of color.
    • Public reporting and website publication of annual compliance findings.

  • Scope of Application:

    • The bill applies to several categories of insurers and plans:
    • Accident and sickness policies (§ 27-18-57)
    • Nonprofit hospital service corporations (§ 27-19-48)
    • Nonprofit medical service corporations (§ 27-20-43)
    • Health Maintenance Organizations (HMOs) (§ 27-41-59)
    • Medicaid-related medical assistance (§ 40-8)

  • Effective Date:

    • The act takes effect upon passage.
    • Coverage for contraceptives is required for policies delivered or renewed on or after January 1, 2027.

3) Who Is Affected

  • Individuals with group or individual health insurance policies in Rhode Island (including plans administered by hospital service corporations, medical service corporations, HMOs, and Medicaid-related programs).
  • Enrollees, their spouses/domestic partners, and their dependents who rely on these plans for prescription contraception, sterilization, and related clinical services.
  • Religious employers and the plans they offer may invoke exemptions for contraceptive coverage consistent with religious tenets.
  • Health insurers and plan sponsors, who must adhere to new coverage, cost-sharing, supply, and reporting requirements.
  • Rhode Island Health Insurance Commissioner and the Executive Office of Health and Human Services, in implementing oversight and reporting.

4) Procedural and Timeline Aspects

  • Enactment and Implementation:
    • If enacted, the coverage mandate becomes effective for contracts delivered, issued for delivery, or renewed on or after January 1, 2027.
  • Regulatory Action:
    • The commissioner (and the Executive Office of Health and Human Services for HMOs/Medicaid-analogous plans) must develop rules and regulations, conduct stakeholder processes, perform random compliance reviews, and publish annual reports.
  • Public Transparency:
    • Annual compliance reports must be publicly accessible on the respective department websites.

Notes

  • The bill explicitly states it does not mandate RU-486 (mifepristone) coverage.
  • The bill includes extensive protections for cost-sharing avoidance and patient access, aligning contraception coverage with current federal therapeutic equivalence definitions and OTC accessibility standards.

Compiled from official sources — confirm details with the bill’s official record.

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