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HB 5991

AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR CHILDREN AND PREGNANT WOMEN

2025 Regular Session Introduced by Karen Alzate and 8 co-sponsors

Expands RI Medicaid/CHIP coverage for pregnant people up to 250% FPL, adds a payor-of-last-resort for uninsured maternity care, and requires self-measured BP monitoring support.

04/30/2025 Committee recommended measure be held for further study
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Bill Summary · HB 5991

Summary — HB 5991: "Health Care for Children and Pregnant Women"

Status: Committee recommended measure be held for further study (04/30/2025)
Introduced: Feb. 28, 2025 (House Finance) — effective upon passage if enacted

Note: The packet provided includes material from two different bill streams. This summary focuses on the Rhode Island act titled “Health Care for Children and Pregnant Women” (Legislative Council bill LC001981 / HB 5991), which contains the health-related provisions described below.

Purpose

The bill directs the Executive Office of Health and Human Services (EOHHS) to expand and formalize prenatal, delivery and postpartum coverage for pregnant persons in Rhode Island by: (1) amending Title XIX/XXI state plans to extend eligibility for certain income levels, (2) creating a “payor of last resort” program for uninsured maternity care (including certain noncitizens), and (3) requiring coverage of self-measured blood pressure monitoring and related supports for pregnant and postpartum individuals.

Key provisions

  • Authorizes EOHHS to amend Medicaid (Title XIX) and CHIP (Title XXI) state plans to provide coverage via expanded family income disregards for pregnant persons with family income between 185% and 250% of the federal poverty level (FPL).
  • Establishes a payor-of-last-resort program to cover prenatal, delivery and postpartum care for persons lacking maternity insurance and not otherwise eligible for Title XIX/XXI — explicitly including some noncitizens lawfully admitted for permanent residence on/after Aug. 22, 1996 — with regulations to specify eligibility, scope, administration, outreach, etc.
  • Enumerates covered maternity services: antepartum/postpartum care, delivery, cesarean, newborn hospital care, inpatient transport (when authorized), prescription drugs and labs.
  • Requires EOHHS to provide enhanced services as appropriate (care coordination, nutrition/social service counseling, high‑risk obstetrical care, childbirth/parenting classes, smoking cessation, substance use counseling, interpreter services, mental health services, home visitation). Enhanced services are subject to available appropriations and may be limited if funding is insufficient.
  • Extends family planning services up to 24 months postpartum for those eligible through RIte Start or Medicaid/CHIP.
  • Confirms that individuals eligible while pregnant (including retroactive eligibility) are entitled to full Medicaid benefits through the last day of the month in which the 12‑month postpartum period ends; federal funds should be used to the maximum extent possible, with state-only funds used if federal participation is unavailable.
  • Requires coverage of self‑measured blood pressure monitoring for pregnant and postpartum persons determined eligible — including provision of validated home BP monitors, reimbursement for provider/staff time for training, data transmission and interpretation, and delivery of co‑interventions (education, behavioral change support, medication management). This benefit is to be provided regardless of availability of federal funds, with state funds used only if federal funds are not available.
  • Clarifies that termination-of-pregnancy services allowed under state law are covered for eligible persons, but federal funds shall not be used for those services except where federal law permits.

Populations affected

  • Pregnant and postpartum persons in Rhode Island with family incomes up to 250% FPL (through expanded income disregards).
  • Uninsured pregnant persons lacking other coverage, including certain lawfully admitted noncitizens.
  • New mothers eligible for extended postpartum benefits and family planning services up to 24 months postpartum.
  • Providers who will deliver and be reimbursed for BP-monitoring services and co-interventions.

Implementation & funding

  • EOHHS is authorized to promulgate regulations and enter cooperative agreements with state agencies to implement programs.
  • The law directs use of federal financial participation where available; state-only funds may be used when federal funds are not available. Enhanced services are explicitly subject to appropriations.
  • The bill takes effect upon passage.

Potential impacts and considerations

  • Likely to increase maternal health coverage and continuity of care (notably through 12‑month postpartum coverage and extended family planning), and improve hypertension detection/management via home BP monitoring — which can reduce morbidity from preeclampsia/other hypertensive disorders.
  • Will require administrative action (state plan amendments, regulations) and budgetary resources; the extent of state fiscal impact depends on federal match availability and appropriation of state funds for enhanced services.
  • Includes explicit provisions limiting federal funding for abortion-related services in line with federal restrictions.

Legislative status

  • Introduced and referred to House Finance (Feb. 28, 2025).
  • Committee hearing scheduled and, as of 04/30/2025, the committee recommended holding the measure for further study. Next steps would typically be reconsideration by the committee, a committee report, and potential floor action if advanced.

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

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