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S2379AHealth Insurance

Health and Safety - Department of Health

This bill requires health insurers to cover state-recommended vaccines for free and legally protects providers who administer them.

Introduced57 Yea14 Nay4 Not voting
Population
Affected
75
Email Legislator
Introduced Jan 30, 2026Committee Senate Health & Human Services

Plain-English Summary

This bill allows the Rhode Island Department of Health director to independently recommend routine childhood and adult vaccines, alongside national advisory committees. It legally protects healthcare providers who administer these recommended vaccines from out-of-state lawsuits. Additionally, it requires all health insurance plans, including Medicaid and state employee benefit programs, to cover these state-recommended vaccines without any out-of-pocket costs (cost-sharing) for patients, starting on January 1, 2027.

For younger readers

This new rule lets the state health department choose which vaccines (shots that keep you from getting sick) are most important for kids and adults. It makes sure that doctors and nurses who give these shots cannot get in trouble with laws from other states. It also says that starting in 2027, health insurance companies—which help pay for doctor visits—must pay for these shots completely, so people don't have to use their own money to get them.

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 markets, Medicaid, and state employee benefits, which are well within state powers. The "Healthcare Provider Shield" provisions (protecting local providers from out-of-state civil or criminal actions for legally protected activities within RI) may face future constitutional tests regarding the Full Faith and Credit Clause or dormant Commerce Clause, but are currently widely enacted and presumed constitutional to protect state sovereignty regarding local healthcare practice.

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Eliminates out-of-pocket costs for state-recommended vaccines, ensuring that low-income and disadvantaged individuals have equal access to essential preventative healthcare without financial barriers.
  • Expands the state's Healthcare Provider Shield laws to protect medical professionals from out-of-state litigation, safeguarding public health workers and preserving access to care.
  • Empowers the state health director to proactively recommend vaccines based on local public health needs rather than waiting solely on federal advisory committees, strengthening community welfare and the social safety net.
  • The elimination of out-of-pocket costs for state-recommended vaccines does not take effect until January 1, 2027, leaving vulnerable populations burdened by potential costs in the interim.
  • Removing the phrase "to the extent permitted by available funds" without explicitly securing new funding sources could strain existing public health budgets and potentially siphon resources from other critical social services.
  • The bill focuses primarily on insured individuals (including Medicaid) but does not explicitly outline how uninsured individuals will access these free vaccines, potentially leaving a gap in healthcare equity.
For Conservatives
  • Protects local healthcare providers and businesses from out-of-state legal harassment, asserting state sovereignty and defending local professionals against overreaching foreign jurisdictions.
  • Provides a clear, standardized set of vaccine recommendations from a single state authority, which could streamline compliance and reduce administrative confusion for medical businesses.
  • Delays the insurance coverage mandate until 2027, giving insurance companies and private businesses ample time to adjust their financial models and premiums to absorb the new requirements.
  • Imposes strict government mandates on private insurance companies by forcing them to cover vaccines without cost-sharing, infringing on corporate freedom and the free market.
  • Grants broad, unilateral power to an unelected state health director to mandate vaccine recommendations without legislative oversight, expanding government overreach.
  • Shields providers from out-of-state lawsuits regarding vaccines, which conservatives may view as a disregard for the rule of law and an obstruction of other states' legal jurisdictions.

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.