A Snapshot of Health Insurance in Rhode Island

Health Insurance Coverage

• 62.3% of Rhode Islanders have employer-sponsored health coverage. (The Lewin Group analysis of the Current Population Survey (CPS))
• The remainder of the State's population is insured through Medicare, Medicaid, the individual market, CHAMPUS (military); have retiree coverage; or are uninsured.
• The rate of uninsurance in Rhode Island has increased since 1999 and has increased faster than across the country. (CPS)

Small Employers Are Struggling To Provide Health Coverage To Employees

• Firms with less than 500 employees make up 96% of businesses in Rhode Island and employ 58% of the workforce. (United States Small Business Administration)
• Small employers have experienced higher rates of increase in health insurance premiums - 22% for small employers and 16.7% for large employers. (Benefits Unlimited, 2002-2003 Annual Health Benefits Trends)
• Employees in small firms are less likely to be insured through their employer. In 2001, less than half (48.4%) of employees in firms sized under 100 were insured through their employer; compared to nearly 70% in firms with 100 or more employees. (The Lewin Group analysis of the CPS)

Premium Increases Are Not Being Shared With Providers

• Some providers in Providence are paid less than their counterparts in other New England cities. (Massachusetts Medical Society, 2002)
• Some providers in Boston, MA; Manchester, NH; Portland, ME; and Hartford, CT are paid twice as much as providers in Providence for services such as outpatient office visits, inpatient hospital days, and appendectomies. (Massachusetts Medical Society, 2002)

States Are Addressing The Problem Of Increasing Health Insurance Premiums

• Small employer purchasing pools increase employers' purchasing power.
• Reinsurance or stop-loss protection limits health insurance carriers' risk.
• Insurance reforms related to mandated benefits, carriers' reserve levels, rate increases, administrative procedures, and the role of the Insurance Commissioner are being considered.
• Tax credits for health insurance premiums help ease the burden for small employers.
• Some states require health education and disease management programs of carriers and sometimes underwrite such efforts.
• RIte Care and RIte Share reforms may improve program participation.
• Maine's Dirigo program uses a combination of strategies to achieve broad-based reform.