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H7625AHealth Insurance

Health and Safety - Department of Health

This bill protects healthcare providers who administer vaccines and requires health insurance to cover recommended vaccines without out-of-pocket costs.

Introduced34 Yea4 Nay0 Not voting
Population
Affected
72
Email Legislator
Introduced Feb 11, 2026Committee House Health & Human Services

Plain-English Summary

This bill updates the state's immunization program by removing language that limited vaccine availability to available funds. It protects healthcare providers from out-of-state legal action for administering or dispensing routine vaccines recommended by the Rhode Island Department of Health. Additionally, it requires all health insurance plans, including Medicaid and state employee benefit programs, to cover these recommended vaccines without any out-of-pocket costs (cost-sharing) for patients, starting on January 1, 2027.

For younger readers

This bill changes rules about vaccines, which are shots that keep you from getting sick. First, it protects doctors and nurses who give these shots from getting in trouble with laws from other states. Second, starting in the year 2027, it makes sure that health insurance—which is a plan that helps pay for doctor visits—must pay for all the shots recommended by the state health department. This means people will not have to pay their own money when they get these recommended shots.

Who & Where It Applies

Impacted groups
Healthcare providersHealth insurance companiesMedicaid beneficiariesState employeesPatients receiving vaccines
Impacted communities
All

Constitutional & Fiscal Check

None Likely. The bill regulates state insurance requirements, Medicaid coverage, and shields local providers from out-of-state civil litigation regarding legally protected healthcare activities. These fall within the state's traditional police powers and regulation of public health. While the shield law provisions could potentially face complex Full Faith and Credit Clause challenges if tested by another state's judgment, the state generally has wide latitude to define and protect legal activities within its own borders.

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Eliminates out-of-pocket costs for vaccines across all insurance types, including Medicaid, ensuring low-income and disadvantaged individuals have equal access to preventative healthcare.
  • Expands the Healthcare Provider Shield to protect medical professionals from out-of-state hostile litigation for providing vaccines, safeguarding healthcare workers and science-based medical practices.
  • Strengthens the state's public health infrastructure by removing funding constraints on the Department of Health's immunization program, promoting the overall welfare of the community.
  • Delays the implementation of the zero-cost-sharing requirement for health insurance and Medicaid until January 1, 2027, leaving vulnerable populations burdened with potential costs until then.
  • Concentrates decision-making power regarding vaccine recommendations in the hands of the Director of Health, which could be risky if a future administration is hostile to public health initiatives.
  • Focuses heavily on insurance and Medicaid coverage but may not adequately address the needs of undocumented immigrants or the completely uninsured who fall outside these systems.
For Conservatives
  • Protect Rhode Island healthcare providers and businesses from out-of-state legal interference, defending state sovereignty and local business operations against foreign judgments.
  • Ensures that private insurance companies and Medicaid managed care organizations operate under a uniform set of coverage rules, creating a predictable regulatory environment for the healthcare industry.
  • Potentially reduces long-term state healthcare costs and Medicaid expenditures by ensuring preventative vaccinations are administered, preventing expensive hospitalizations for preventable diseases.
  • Imposes strict new coverage mandates on private health insurance companies, restricting corporate freedom and potentially driving up insurance premiums for everyone.
  • Expands government assistance by mandating that Medicaid and state employee benefit programs cover all recommended vaccines with zero cost-sharing, which could increase taxpayer burdens.
  • Grants broad, unilateral authority to the unelected Director of the Department of Health to determine which vaccines are necessary, limiting personal medical freedom and bypassing legislative oversight.

Votes

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Full Bill Text

2 versions
Changes to existing Rhode Island law · 75 additions · 13 deletions

It is enacted by the General Assembly as follows:

SECTION 1. Section 23-1-44 of the General Laws in Chapter 23-1 entitled "Department of Health" is hereby amended to read as follows: 23-1-44. Routine childhood and adult immunization vaccines.

(a) The department of health shall include in the department’s immunization program those vaccines for routine childhood immunization as recommended by the Advisory Committee for Immunization Practices (ACIP) and the Academy of Pediatrics (AAP) or as determined by the director of the department of health to be necessary to protect the public health, and for routine adult immunization as recommended by the ACIP, or as determined by the director of the department of health to be necessary to protect the public health to the extent permitted by available funds. The immunization program includes administrative and quality assurance services and the Rhode Island Child and Adult Immunization Registry (RICAIR), a confidential, computerized information system that is used to manage statewide immunizations, for all persons in Rhode Island.

(b) The director of the department of health shall appoint an advisory committee that will be convened after the ACIP makes a recommendation regarding immunization at the discretion of the director. The committee will review the ACIP recommendations for the state and director- initiated proposals for the state; assess the vaccine cost and feasibility; and advise the director of health and the office of the health insurance commissioner regarding insurers and providers acting on the ACIP immunization recommendation immunization recommendations or proposals. All recommendations will be posted on the department of health website. The advisory committee membership shall include, but not be limited to, a primary care provider, an epidemiologist, a pharmacist, major insurers, and at the discretion of the director, representatives of the nursing home industry, and the home healthcare industry and major insurers.

(c) For the purpose of protecting patients’ information, all personally-identifiable information obtained pursuant to this section shall be subject to the privacy protections of chapter 37.3 of title 5 and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191 (HIPAA), as amended.

SECTION 2. Section 23-101-2 of the General Laws in Chapter 23-101 entitled "Healthcare Provider Shield" is hereby amended to read as follows: 23-101-2. Definitions. As used in this chapter, the followings words shall have the following meanings unless the context clearly indicates otherwise:

(1) “Aggrieved person” means:

(i) A person against whom hostile litigation is filed or prosecuted or the legal representative of a person against whom hostile litigation is filed or prosecuted; or

(ii) The employer of a person against whom hostile litigation is filed or prosecuted if the legally protected healthcare activity or aiding and assisting legally protected healthcare activity of the person that forms the basis of the hostile litigation was performed within the scope of the person’s employment.

(2) “Aid and assist legally protected healthcare activity” and “aiding and assisting legally protected healthcare activity” mean:

(i) Any act or omission of a person aiding or effectuating or attempting to aid or effectuate any other person in legally protected healthcare activity; or

(ii) The provision or administration of, or attempted provision or administration of, insurance coverage for gender-affirming healthcare services or reproductive healthcare services to a beneficiary or a dependent of a beneficiary by any insurer, payor, or employer.; or

(iii) The prescription or administration, dispensing, or provision of, or attempted administration, dispensing, or provision of, a vaccination pursuant to the routine childhood and adult immunization vaccine recommendations that are developed under § 23-1-44; or (iii)(iv) “Aiding and assisting legally protected healthcare activity” does not include any conduct that violates Rhode Island law or deviates from the applicable standard of care or that could form the basis of a civil, criminal, or administrative action under the laws of this state had the course of conduct that forms the basis for liability occurred entirely within this state.

(3) “Foreign judgment” means any judgment or decree of a court of another state.

(4) “Gender-affirming healthcare services” means all supplies, care, and services of a medical, behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventive, rehabilitative, or supportive nature, including medication, relating to the treatment of gender dysphoria and gender incongruence in accordance with the accepted standard of care as defined by major medical professional organizations and agencies with expertise in the field of gender- affirming health care, including the Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, or subsequent version, published by the World Professional Association for Transgender Health. “Gender-affirming healthcare services” does not include conversion therapy as defined by § 23-94-2.

(5) “Healthcare provider” means and shall apply to the following:

(i) A qualified physician licensed pursuant to chapters 37 and 37.3 of title 5;

(ii) A qualified osteopathic physician licensed pursuant to chapter 37 of title 5;

(iii) A qualified physician assistant licensed pursuant to chapter 54 of title 5;

(iv) A genetic counselor licensed pursuant to chapter 92 of title 5;

(v) A qualified psychologist licensed pursuant to chapter 44 of title 5;

(vi) A qualified social worker licensed pursuant to chapter 39.1 of title 5;

(vii) An advanced practice registered nurse, and a certified nurse practitioner, licensed pursuant to chapter 34 of title 5, and a certified registered nurse anesthetist licensed pursuant to chapters 34 and 34.2 of title 5;

(viii) A certified nurse midwife licensed pursuant to chapter 13 of this title;

(ix) A licensed clinical mental health counselor or associate, and a licensed marriage and family therapist or associate, licensed pursuant to chapter 63.2 of title 5;

(x) An electrologist licensed pursuant to chapter 32 of title 5;

(xi) A speech-language pathologist licensed pursuant to chapter 48 of title 5;

(xii) An occupational therapist licensed pursuant to chapter 40.1 of title 5;

(xiii) A chiropractic physician licensed pursuant to chapter 30 of title 5; and

(xiv) A pharmacist engaging in the practice of pharmacy and licensed pursuant to chapter 19.1 of title 5.

(6) “Hostile litigation” means any litigation or other legal action, including civil, criminal, or administrative action, to deter, prevent, sanction, or punish any person engaging in legally protected healthcare activity or aiding and assisting legally protected healthcare activity by:

(i) Filing or prosecuting any litigation or other legal action in any other state where liability is based on legally protected healthcare activity or aiding and assisting legally protected healthcare activity that occurred in this state, including any action in which liability is based on any theory of vicarious, joint, or several liability; or

(ii) Attempting to enforce any order or judgment issued in connection with any litigation or other legal action under subsection (6)(i) of this section by any party to the action or by any person acting on behalf of any party to the action.

(iii) For purposes of this chapter, litigation or other legal action is based on legally protected healthcare activity or aiding and assisting legally protected healthcare activity that occurred in this state if any part of any act or omission involved in the course of conduct that forms the basis for liability in the action occurs or is initiated in this state, whether or not the act or omission is alleged or included in any pleading or other filing in the lawsuit.

(7) “Law enforcement agency” means any police department in any city or town or the state police as defined in the general laws. For purposes of this act, a law enforcement agency may include any other non-federal entity in the state charged with the enforcement of laws relating to the custody of detained persons.

(8) “Legally protected healthcare activity” means:

(i) The exercise and enjoyment or attempted exercise and enjoyment by any person of the right secured by this state to gender-affirming healthcare services or reproductive healthcare services; and

(ii) The provision or attempted provision of gender-affirming healthcare services or reproductive healthcare services that are permitted under the laws and regulations of this state and that are provided in accordance with the applicable standard of care by a person properly licensed under the laws of this state and physically present in this state, regardless of whether the patient is located in this state or whether the person is licensed in the state where the patient is located at the time the services are rendered.; and

(iii) The provision or attempted provision of a routine childhood or adult immunization vaccine under § 23-1-44. (iii)(iv) “Legally protected healthcare activity” does not include any conduct that could form the basis of a civil, criminal, or administrative action under the laws of this state had the course of conduct that forms the basis for liability occurred entirely within this state and/or in violation of Rhode Island law.

(9) “Reproductive healthcare services” means all supplies, care, and services of a medical, behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventive, rehabilitative, or supportive nature, including medication, relating to pregnancy, contraception, assisted reproduction, pregnancy loss management, or the termination of a pregnancy in accordance with the applicable standard of care as defined by major medical professional organizations and agencies with expertise in the field of reproductive health care.

(10) "Routine childhood and adult immunization vaccine recommendations" means vaccine recommendations as determined by the director of the department of health to be necessary to protect the public health under § 23-1-44. (10)(11) “State” means a state of the United States, the District of Columbia, Puerto Rico, the United States Virgin Islands or any territory or insular possession subject to the jurisdiction of the United States. The term “this state” refers to the state of Rhode Island.

SECTION 3. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section: 27-18-96. Coverage for vaccinations. Every individual or group medical service contract or every individual or group hospital or medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH).

SECTION 4. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section: 27-19-88. Coverage for vaccinations. Every individual or group medical service contract or every individual or group hospital or medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH).

SECTION 5. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section: 27-20-84. Coverage for vaccinations. Every individual or group medical service contract or every individual or group hospital or medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH).

SECTION 6. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section: 27-41-101. Coverage for vaccinations. Every individual or group medical service contract or every individual or group hospital or medical expense insurance policy, plan or group policy delivered, issued, or renewed in this state on or after January 1, 2027, shall provide coverage, without cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH).

SECTION 7. Chapter 40-8 of the General Laws entitled "Medical Assistance" is hereby amended by adding thereto the following section: 40-8-33. Coverage for vaccinations. Commencing January 1, 2027, the medical assistance program shall provide coverage, without cost-sharing, for all vaccinations recommended by the Rhode Island department of health (RIDOH). This recommendation shall apply to all Medicaid beneficiaries, whether enrolled in fee- for-service or managed care, to the extent permitted under federal law.

SECTION 8. Chapter 40-8.5 of the General Laws entitled "Health Care for Elderly and Disabled Residents Act" is hereby amended by adding thereto the following section: 40-8.5-1.2. Coverage for vaccinations.

(a) As used herein, "managed care systems" is defined as systems that: integrate an efficient financing mechanism with quality service delivery; provide a “medical home” to ensure appropriate care and deter unnecessary services; and place emphasis on preventive and primary care. For purposes of this section, managed care systems may also be defined to include a primary care case- management model, community health teams, and/or other such arrangements that meet standards established by the executive office and serve the purposes of this section. Managed care systems may also include services and supports that optimize the health and independence of beneficiaries who are determined to need Medicaid-funded long-term care under chapter 8.10 of this title (“long- term care service reform for Medicaid eligible individuals”) or to be at risk for the care under the applicable federal state plan or waiver authorities and the rules and regulations promulgated by the executive office. Any Medicaid beneficiaries who have third-party medical coverage or insurance may be provided such services through an entity certified by, or in a contractual arrangement with, the executive office or, as deemed appropriate, exempt from mandatory managed care in accordance with rules and regulations promulgated by the executive office.

(b) Commencing January 1, 2027, any Medicaid managed care organizations under contract with the executive office of health and human services shall provide coverage, without cost-sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH), to the extent permitted under federal law.

SECTION 9. Chapter 36-12 of the General Laws entitled "Insurance Benefits" is hereby amended by adding thereto the following section: 36-12-2.1.1. Coverage for vaccinations. Commencing January 1, 2027, the director of administration shall administer health benefit programs for state employees and retirees, and shall ensure that coverage is provided, without cost- sharing, for vaccinations recommended by the Rhode Island department of health (RIDOH).

SECTION 10. Severability. If any section of this act or its application to any person or circumstance is held invalid, the invalidity shall not affect other sections or applications of the act that can be given effect without the invalid section or application, and to this end the sections of this act are declared severable.

SECTION 11. This act shall take effect upon passage.