Tag Archives for Medicaid

Medicare and Medicaid at 60: Historic Milestones, Looming Changes

Published in RINewstoday on August 4, 2025

As 68 million Medicare beneficiaries recognize the 60th anniversary of Medicare, changes are coming to these landmark programs. Presented as efforts to slash costs and combat fraud, the thought of change to Medicare in almost any way leaves many older Americans feeling threatened that their health and financial security will be impacted in a negative way.

A Legacy Under Threat – or Repair?

On July 30, 1965, President Lyndon B. Johnson signed H.R. 6675 into law during a ceremony at the Truman Library in Independence, Missouri. Lasting between 45 and 60 minutes, the event marked the official creation of Medicare and extended guaranteed health coverage to 16 million Americans aged 65 and older—coverage that had not previously existed.

Former President Harry Truman, who had fought for national health insurance two decades earlier, was present for the ceremony. He was enrolled as Medicare’s first beneficiary and received the first Medicare card at the event.

Speaking at the bill signing, President Johnson declared, “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime… No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents.” Johnson concluded, “When the final chapter of this generation is written, it will be said that we met the needs of the old, and that we did not abandon them to the despair and loneliness and hardship that comes when illness strikes the aged.”

Today, Medicare provides universal health coverage to Americans age 65 and older—though, as the National Committee to Preserve Social Security and Medicare (NCPSSM) humorously noted in its blog, “Ironically, the program is not yet old enough to qualify for itself.”

 The law created Part A to provide hospital insurance funded through payroll taxes and Part B to cover doctor visits and outpatient services on a voluntary basis. Part C, known as Medicare Advantage, offers a privatized, for-profit alternative to traditional Medicare. Part D (coverage through private, for-profit insurers rather than through the traditional Medicare program), added in 2003, provides coverage for prescription drugs. Over the years, Medicare has evolved to offer a wider range of services, yet it still falls short in some areas. Efforts to expand coverage to include essential benefits like dental, hearing, and vision have repeatedly failed to pass Congress.

Medicaid is a federal-state program that offers health coverage to low-income individuals, including children, pregnant people, and those with disabilities — in addition to covering long-term care for eligible seniors. It is a key funding source for U.S. safety net healthcare providers.

NCPSSM’s President and CEO, Max Richtman said that, “We should take a moment to marvel at the fact that — like Social Security — Medicare was created by national leaders who had a vision of a more just society, where, instead of leaving older people to get sick and die in poor houses or becoming a burden to their children, America would commit itself to providing basic health (and financial) security to our most vulnerable citizens.  Through the foresight of Franklin D. Roosevelt and Lyndon Johnson, these benefits (Medicare Part A and Social Security) would be earned through workers’ payroll contributions, giving Americans a true stake in insuring themselves against the hardships of aging.”

What’s at Stake

Despite Medicare’s broad support, it has frequently come under political attack, often rationalized by concerns over its long-term financial viability. The most recent Medicare Trustees report projects that the program’s Part A trust fund could be depleted by 2033 if Congress does not act. At this point the fund’s reserves would only be able to pay 90% of the total scheduled benefits in what there is to spend on Part A.

In 2025, following weeks of political discourse, the “Big Beautiful Bill” was signed into law on July 4, 2025. Known formally as H.R. 1, the sweeping 900-page legislation passed the House on May 22 by the razor-thin margin of 215–214–1. Every House Democrat opposed the measure. Two Republicans joined them. Freedom Caucus Chair Andy Harris of Maryland voted “present.” Two Republican members abstained.

Richtman, sharply criticized the law, saying it “rips health coverage away from as many as 16 million Americans and food assistance from millions more.” Its Richtman’s opinion to warn that 7.2 million seniors who are dually enrolled in Medicare and Medicaid, and another 6.5 million who rely on SNAP (Supplemental Nutrition Assistance Program), stand to lose vital support for health care and nutrition.

The Center for Medicare Advocacy (CMA) also raised serious concerns. CMA is a national, non-profit law organization, working to advance access to Medicare and quality health care through advocacy on behalf of older and disabled people. They warn that Medicare is being steadily privatized. More than half of all beneficiaries now receive their care through Medicare Advantage plans, which costs taxpayers approximately 20 percent more than traditional Medicare. These plans often restrict access to care through networks and pre-authorization requirements. CMA estimates that the $84 billion in overpayments to Medicare Advantage plans this year alone could instead have funded comprehensive dental, vision, and hearing coverage for every Medicare recipient.

CMA further maintains that H.R. 1 strips Medicare coverage from certain lawfully present immigrants who had earned eligibility through their work histories. Undocumented immigrants are not eligible for Medicare. It also blocks implementation of enhancements to the Medicare Savings Program that would have helped low-income beneficiaries afford care, stops new federal nursing home staffing standards estimated to have the potential to save 13,000 lives per year, and limits Medicare’s ability to negotiate lower drug prices for some of the most expensive medications.

Medicaid, enacted alongside Medicare in 1965 to serve low-income individuals and families, faces even steeper reductions under H.R. 1. The law’s new eligibility restrictions are projected to cause from 10-16 million people to lose coverage.

Medicaid Fraud, Waste, and Abuse

Medicaid fraud, like other forms of healthcare fraud, involves intentionally submitting false information to receive payment for services not rendered, unnecessary services, or inflated claims. This fraudulent activity has serious consequences, harming patients, honest providers, and taxpayers. In 2024, the national Medicaid improper payment rate was estimated at 5.09%, translating to $31.1 billion in federal Medicaid improper payments. Medicaid Fraud Control Units (MFCUs) recovered $1.4 billion in FY 2024, representing a return of $3.46 for every $1 spent. Criminal recoveries in FY 2024 were the highest in 10 years, reaching $961 million, more than double the five-year average.

In 2024, 8% of Medicaid claims were deemed improper payments due to fraudulent practices. Fraudulent billing for services not rendered or exaggerated in complexity (upcoding or ghost billing) was a common theme in 2024 fraud cases. Misuse of telehealth and the involvement of third-party billing firms were also notable trends in Medicaid fraud cases in 2024. Prescription drug scams, especially involving opioids and controlled substances, remain among the most significant Medicaid fraud cases. Medicaid fraud in managed care settings increased by 30% in the past five years.

Examples of recipient fraud include lending or sharing a Medicaid Identification card; forging or altering a prescription or fiscal order, using multiple Medicaid ID cards, re-selling items provided by the Medicaid program, and selling or trading the card or number for money, gifts or non-Medicaid services.

Examples of provider Fraud, Waste, and Abuse include billing for Medicaid services that were not provided or for unnecessary services, selling prescriptions, intentionally billing for a more expensive treatment than was provided, giving money or gifts to patients in return for agreeing to get medical care, and accepting kickbacks for patient referrals.

Rhode Island Senators React 

In response to the changes in H.R. 1, Rhode Island’s U.S. Senators Jack Reed and Sheldon Whitehouse joined the entire Senate Democratic caucus to introduce S. 2556 on July 30, the 60th anniversary of Medicare and Medicaid. This three-page bill seeks to repeal the health care cuts included in H.R. 1 and permanently extend the Affordable Care Act’s enhanced tax credits, which are set to expire at the end of 2025. Full Democratic caucus sponsorship of legislation—led in this case by Senate Minority Leader Chuck Schumer—is exceptionally rare and underscores their urgent need to call out the Big Beautiful Bill for its healthcare changes.

S 2556 has been referred to the Senate Finance Committee and at press time no House companion measure has been introduced.

Senator Reed emphasized the wide-reaching impact of H.R. 1, saying that millions of people are expected to lose health coverage under the combined effects of the bill’s Medicaid and ACA cuts. The repercussions, he said, will be felt by health clinics, hospitals, seniors, nursing homes, and patients across the country.

According to an analysis by KFF (formerly the Kaiser Family Foundation) 43,000 Rhode Islanders could lose health coverage due to the bill. Of those, 38,000 would lose insurance as a result of Medicaid cuts, and another 5,500 due to changes in the Affordable Care Act. The same analysis projected that Rhode Island would lose $3 to 5 billion in federal Medicaid funding over the next decade due to the law’s provisions.

Reed also noted that the bill includes cuts to the SNAP (food stamps) program—reducing federal funding by 20 percent through 2034. States would have the option to pick up the difference using their own funds.  In Rhode Island, where 1/3 of the population is on social welfare assistance of some kind, including Medicaid and SNAP, an estimated 144,000 Rhode Islanders are expected to lose SNAP benefits entirely. To maintain SNAP provisions in Rhode Island, the estimated cost could be as high as $51 million.

Reed explained that without ACA premium tax credits, younger workers will also face rising health insurance premiums beginning in 2026, putting additional financial strain on working families. When people lose access to health insurance, they are more likely to delay or skip care, leading to poorer health outcomes and higher overall costs. Federal law would still require hospitals to provide emergency care, meaning hospitals will absorb the financial burden when patients cannot pay. There are also new limits on how medical costs can be held against individuals, especially in Rhode Island, with provisions against destroyed credit ratings, liens, and bankruptcy moves.

BBB Supporters Say It’s a Pill We May Need

According to supporters of H.R. 1, recent changes to Medicare, Medicaid, and SNAP may be seen as fearful, but positive, because they improve affordability, access, and long-term health outcomes.  They says that H.R. 1. Medicare’s new $2,000 cap on drug costs protects seniors from crushing out‑of‑pocket expenses. Medicaid’s pilot coverage for obesity treatments like GLP‑1 drugs supports preventative care and could reduce chronic illness. Meanwhile, efforts to modernize SNAP enrollment and target benefits more effectively aim to reduce administrative waste and better serve low‑income families. However, the introduction of new SNAP work requirements, while controversial, is intended to encourage workforce or volunteer participation among beneficiaries. These reforms reflect a broader commitment to updating essential safety net programs, making them more efficient, equitable, and responsive to today’s health and economic realities—without sacrificing core benefits, supporters add.

A New Reality

As aging advocates and policymakers mark the 60th anniversaries of Medicare and Medicaid, they are forced to address a new reality in both programs. Rather than continually expanding to meet growing needs of older adults, these programs now face reductions that could lead to challenges in access, lower quality care, increased paperwork, disruption in treatment, higher premiums, and fewer covered services. Provider reimbursements are also expected to be cut, which may further limit access to care.

Instead of being a milestone for celebration, the 60th anniversary of Medicare and Medicaid has become a turning point for aging advocate groups—marking not progress, but threat for millions of older Americans who depend on these essential programs to live with dignity, independence, and health.

Caregiver Crisis:  New Report Gives a “Wake Up” Call to Congress

Published in RINewsToday on July 28, 2025

After a media briefing last week, AARP and the National Alliance for Caregiving (NAC) released a report, Caregiving in the U.S. 2025, that warns of a looming crisis that will impact America’s 63 million caregivers, an increase of 45% over the past decade. The report noted that caregivers are at a “crisis point.” Nearly half reported major financial problems, one in five reported fair or poor health, and more troubling, nearly a quarter felt completely alone.

Congress and state policy makers must grapple with this demographic time bomb, the researchers say. With the graying of America, the number of the nation’s caregivers is skyrocketing. Today, nearly 1 in 4 adults provide ongoing caregiving to an adult or child with a complex medical condition or a disability in the past year. That’s up a whopping 20 million since 2015.

And the “sandwich generation” (caring for children and adults simultaneously) went from 11 million caregivers in 2015 to a whopping 17 million in 2025.

According to AARP, the first report, Caregiving in the U.S. (released in 1997 by the AARP and NAC), is widely regarded as one of the most authoritative data resources on family caregivers in America. The study has been repeated in 2004, 2009, 2015, and 2020, with each edition providing updated information on caregiver demographics and other factors affecting caregiving. This year’s 133-page report is the most comprehensive study of this critical area of American life to date.

Educating the Nation’s Media about Caregiving Issues

At the 52-minute zoom briefing, AARP CEO Myechia Minter-Jordan, stated, “We need systems that see caregivers, value them and support them because they are not just helping families.  They’re holding up the entire health care system.”

“Caregiving consistently ranks as one of the important issues to our members across age, geography, race and income,” says Minter-Jordan, calling it a bipartisan issue. “Today’s report is a wakeup call, but it’s also an opportunity to act and we hope it drives real lasting change,” she adds.

Adds Jason Resendez, NAC’s President and CEO, the nature of caregiving is growing more medically complex, with care that had once took place in clinics and hospitals. “We’re talking about managing catheters, administering injections and managing medical equipment. But here’s what’s truly troubling. We’re failing to prepare family caregivers for these responsibilities,” he said.

“We must center caregivers in our policy discussions, not as an afterthought, but as a priority because caregiving is infrastructure, it’s health care and it’s essential to our communities and economies,” says Resendez.

A family caregiver shared her personal story of taking care of her mother with dementia for over 10 years, illustrating the personal and financial tolls caregivers make. “I didn’t plan for this, I stepped into the role because someone I loved needed me.  That meant taking time off working and eventually leaving my career in the fashion industry to become my mom’s full-time caregiver, says Alma Valencia, from Pasadena, California.  “I hope that one day soon people like me won’t have to do this alone,” says Valencia.

The July 15 press briefing and the releasing of the report is intended to be a “wake up call” to influence public awareness and drive policy changes at the state and federal levels.  It was brought up that 8 million family caregivesr relied on Medicaid for their own health coverage, making them vulnerable to Congressional Medicaid cuts and stricter eligibility requirements.  By providing stark data on the growth and complexity of caregiving, AARP and NAC hope to influence legislative and administrative decisions affecting Medicaid program.

Painting a Picture of America’s Caregivers

Family caregivers—spanning all ages, races, incomes, and communities—include parents, friends, neighbors, and even children. They help with daily tasks such as mobility, personal care, financial management, and medical procedures. This report explores the essential role these caregivers play in the nation’s fragmented long-term care system, examining both the policies that support them and the gaps that remain.

Who are America’s caregivers?

According to this year’s caregiving report, 61% of the nation’s caregivers are women, while 39% are men.

Although the average caregiver is 51 years old, nearly half are under the age of 50.

Twenty-nine percent of caregivers belong to the “sandwich generation,” providing care for both children and adults. Additionally, 18% have a disability themselves, and 27% care for someone with dementia or cognitive impairment.

Links at the end of this commentary provide further detail on caregiver demographics, including ethnicity, race, income, gender, sexual orientation, and geography.

The findings from Caregiving in the U.S. 2025 underscore that caregiving is more than a role—it’s a full-time job.  Nearly 1 in 4 caregivers report providing over 40 hours of care per week. One-third say they have been caregiving for five years or more.

The latest caregiving report notes that America’s “Sandwich Generation” are stretched very thin.  Nearly 1 in 3 caregivers are also raising children under 18 while caring for an adult loved one. This figure rises to 47% among caregivers under 50 and is especially common among Latino (43%) and Black (36%) caregivers.

Caregiving hits you in your pocketbook, the report documenting that financial strain is widespread.  Nearly half of caregivers experienced at least one major financial impact—such as taking on debt, stopping savings. One in five can’t afford basic needs like food and housing.  Rural caregivers are impacted more because they have less access to affordable services. The challenge is greatest for younger, lower-income, Black, Latino, and LGBTQ+ caregivers, the researchers say.

And the report’s findings indicate that the vast majority are still unpaid. While 11.2 million family caregivers now receive some compensation, most are still unpaid. Paid family caregivers are more likely to be younger, lower-income, and racially diverse.

Workplace support is vital  for assisting caregiver workers and there is a growing need for companies to step the plate to help these individuals.  The report found that 7  in 10 family caregivers are employed on top of their family caregiving responsibilities forcing them to balance these dual responsibilities; half of them report experiencing work disruptions like going in late or leaving early to care for a loved one. More family caregivers than ever report having access to family caregiving related benefits like flex time and caregiving assistance. Salaried workers have dramatically better access to benefits.

Caregivers are facing significant health issues by the burden’s they cope with. One in 5 caregivers report being in fair or poor health, and nearly 23% say they struggle to care for their own health due to caregiving responsibilities. Reports of emotional stress have risen since 2020, with 4 in 10 say they are experiencing emotional stress.

A training gap exists for those caregivers performing more medically complex tasks.  Only 11% of caregivers say they have received medical training to assist with Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs), yet the report finds that 50% of the caregivers help with these tasks. The report finds that just over 20% of caregivers have received formal training on medical and nursing tasks despite over half managing complex medical and nursing tasks like injections, wound care, or medication management – yet 65% of caregivers are helping with any ADLs and almost all caregivers help with any IADLs.

Social isolation can significantly impact both mental and physical health, leading to increased risks of depression, anxiety, cognitive decline, and various physical ailments. The report’s findings suggest that caregivers feel more alone and isolated.  Nearly 1 in 4 caregivers report feeling socially isolated—a number that’s growing. Women, LGBTQ+ caregivers, and those who felt they had no choice in becoming caregivers are significantly more likely to report feeling alone.

Finally, the caregiving report called for more support systems to be in place and noted that the existing resources are not keeping pace with the rising demand for family care. Caregivers overwhelmingly support tax credits (69%), paid leave (55%), and programs that pay family caregivers (68%). Almost 40% say respite services would be helpful.

The report calls for immediate, sustained action in policy and practice — from expanding paid leave and respite services to ensuring financial, emotional, and training supports reach the caregivers who need them most.

What’s New in AARP/NAC’s 2025 Caregiver Report?

What is new in the 2025 report?  According to AARP, state-level data will now be available, with a separate state report to be released in Fall 2025.  Also, for the first time, information is now available to characterize the more than 11 million “paid family caregivers” who participate in caregiver payment programs, such as the Medicaid home and community-based (HCBS) self-direction waivers.  And more data on the caregiver experience is available on care coordination and use of other caregiving help, via an expanded Level of Caregiving Complexity Index, in the latest caregiver report.

A final note…

The caregiving crisis is not a partisan issue—it’s an American issue. With over 63 million caregivers anchoring the nation’s health and long-term care systems, Congress and state leaders from both sides of the aisle must rise to meet the changes of this moment. Whether through expanding paid leave, offering targeted tax credits, strengthening Medicaid, or investing in caregiver training, there is broad public support for common-sense solutions. With the release of the 2025 Caregiver Study, AARP and NAC have delivered strong evidence; now it’s time for policymakers—both Republican and Democrat alike to act swiftly—to come together to this Congressional session to craft durable, bipartisan reforms that recognize caregivers not as an afterthought, but as the backbone of our communities.

The Caregiving in the U.S. 2025 survey used a nationally representative, probability-based online panel from IPSOS. The study surveyed 6,858 caregivers aged 18 or older who had provided care for an adult relative or friend 18+, or a child with a complex medical condition or disability within the past 12 months.

The 2025 study was funded by AARP, Pivotal, The Ralph C. Wilson, Jr. Foundation, Novo Nordisk, Genworth, New York Life, Home Instead, Archstone Foundation, The John A. Hartford Foundation, and Mass Mutual.

LINKS to resources – click on the hyperlink to be taken directly to the report:

To get a copy of Caregiving in the U.S. 2025

To watch the AARP-NAC Press Briefing

For more information about the report and – Caregiving in the US

Breaking Downing Caregiver Profiles 

For African American/Black Family Caregivers

For Hispanic/Latino American Family Caregivers,

For Asian American, Native Hawaiian, and Pacific Islander Family Caregivers

For LGBTQ + Family Caregivers

For Rural Family Caregivers

For Lower-Income Family Caregivers

For Family Caregiving by Gender

For High-Intensity Family Caregivers

For Younger Family Caregivers

For Family Caregivers with Disabilities

Aging Policy in 2025: Rhode Island Legislative Wins and What’s Missing

Published in RINewsToday.com, July 14, 2025 

On June 24, 2025, with a 35-2 vote in the Senate, the Rhode Island General Assembly has given its approval to a $13.963 billion budget for the 2026 fiscal year that directs additional funding toward addressing the state’s housing and homelessness crisis, improving access to health care, supporting municipalities through increased revenue sharing, more funding for the state’s Rhode Island Public Transit Authority, extending childcare subsidies for toddlers and infants, and increasing Medicaid reimbursement to primary care providers, nursing homes and hospitals, among its directives.

Faced with a slowing economy and impending federal budget cuts, lawmakers were tasked with closing a $250 million deficit without resorting to broad tax hikes or cuts to essential services. To generate revenue, they implemented new electric vehicle (EV) registration fees, adjustments to the gas tax, and increases in real estate conveyance and hotel taxes. Additionally, tolls on large trucks (18-wheelers), which were approved in 2016 but delayed due to litigation from the trucking industry, are now set to be implemented following the state’s legal victory. The FY 2026 budget includes revenue from these tolls, which are scheduled to take effect.

According to Larry Berman, House Director of Communications, when the dust settled at the conclusion of this year’s 164-day legislative session, lawmakers introduced 1,430 bills and resolutions in the House and 1,165 in the Senate. Of those, the Governor signed 384 House and Senate bills into law, while another 125 became law without his signature.

The Governor is not required to act on resolutions. During the session, the House passed 238 resolutions and the Senate passed 127, most of which expressed congratulations or condolences, says Berman.

As Rhode Island’s population continues to age, advocacy organizations urged lawmakers to consider an array of legislation aimed at enhancing the delivery of state programs and services for older residents—and strengthening protections for their health, safety, financial security, and overall well-being.

Below is a selection of key laws enacted, organized by category:

Healthcare and Insurance

Lawmakers increased insurance coverage for hearing aids from $1,500 to $1,750 per ear, applicable to all ages. Additionally, the new law allows for hearing aid purchases every year, rather than every three years. Sponsored by Rep. Carol Hagan McEntee (D-Dist. 33, South Kingstown, Narragansett), H 5218,  and Sen. Leonidas P. Raptakis (D-Dist. 33, Coventry, West Greenwich, S 0120, this legislation has been signed by the Governor.

The General Assembly passed S 0610B introduced by Senate President Valarie J. Lawson (D-Dist. 14, East Providence) and Rep. Kathleen A. Fogarty’s (D-Dist. 35, South Kingston), bill, H 5494A.  The new law provides new consumer protections for Medicare Supplement Insurance (Medigap) and aligns Rhode  Island’s market with neighboring states. Additionally, the budget expanded the Medicare Savings Program, helping more beneficiaries with premiums and co-pays.

With the passage of S 0169A  sponsored by Sen. Jacob E. Bissaillon (D-Dist. 1, Providence) and H 5184A by Rep. Mary Ann Shallcross Smith (D-Dist. 46, Lincoln, Pawtucket), the new law protects homeowners from medical debt-related liens on their primary residence. Medical bills are among the top reasons underlying bankruptcy among Americans. This law takes effect on Jan. 1.

Senate President Lawson and Rep. Joshua J. Giraldo (D-Dist. 56, Central Falls) sponsored S 0974aa and H 6066A to expand paid family leave under the Temporary Care Insurance (TCI) program. Starting in January 2027, the TCI wage replacement rate will increase from 60% to 70%, and then to 75% in January 2028. This expansion is funded through a modest increase in the payroll contribution cap, which will not impact the state budget.

Consumer Protections and Financial Legislation

The General Assembly passed S 0016A and H 5121A, introduced by Senate Artificial Intelligence & Emerging Technologies Committee Chairwoman Victoria Gu (D-Dist. 38, Westerly, Charlestown, South Kingstown) and Rep. Julie A. Casimiro (D-Dist. 31, North Kingston, Exeter). Signed by the Governor, the new law aims to prevent scams involving cryptocurrency ATMs, a growing fraud scheme in Rhode Island. 

According to AARP, recently 11 states have passed laws or regulations that put key consumer fraud protections on cryptocurrency ATMs in place. Americans lost more than $246 million to crypto ATM fraud and scams in 2024 alone, and older adults are disproportionately targeted by criminals.

With the passage of H 5042A and S 0229A, sponsored by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls) and Sen. Ana B. Quezada (D-Dist. 2, Providence), a new law eliminates the special exemption that allowed payday lenders to charge exorbitant interest rates of up to 260% APR. This reform helps protect consumers from falling into predatory debt cycles.

Lawmakers passed H 5185A and S 0133A sponsored by Rep. Susan R. Donovan (D-Dist. 69, Bristol, Portsmouth) and Sen. Matthew L. LaMountain (D-Dist. 31, Warwick, Cranston).  Signed into law by Gov. Dan McKee, it prohibits predatory real estate practices that often target older homeowners, preventing them from facing liens or other issues related to their properties.  The bill is based on model legislation that has been adopted in 30 other states. The legislation was backed by AARP, the American Land Title Association and the National Association of Realtors.

Support for Vulnerable Populations

Rep. Tina L. Spears (D-Dist. 36, Charlestown, New Shoreham, South Kingstown, Westerly) and Sen. Todd M. Patalano (D-Dist. 26, Cranston) sponsored H 6165A and S 0983A to create the PURPLE Alert system. Signed into law, this new initiative is designed to quickly locate missing adults with serious disabilities whose health and safety are at risk.

Legislation (S 0381A / H 5833A), sponsored by Senate Majority Leader Frank A. Ciccone III (D-Dist. 7, Providence, Johnston) and Rep. Mary Ann Shallcross Smith, now law, allows licensed hairdressers to provide in-home services to individuals with special needs or sensory-related disorders. This new law ensures that such services are provided in accordance with individual care plans verified by a licensed healthcare professional.

Now law, (H 5017A/ S 0884), sponsored by Rep. Samuel A. Azzinaro (D-Dist. 37, Westerly),  and Sen. Walter S. Felag Jr. (D-Dist. 10, Warren, Bristol, Tiverton), protects veterans from improper conduct or excessive fees by individuals assisting them in filing disability claims with the Department of Veterans Affairs, except as authorized by federal law, and it imposes penalities under the deceptive trade practices provisions.

The General Assembly passed legislation (S 0884 / H 5017A) that grants people the right to repair their own complex power wheelchairs and mobility aids. Sponsored by Sen. Mark McKenney (D-Dist. 30, Warwick) and Rep. Grace Diaz (D-Dist. 11, Providence), this new law requires manufacturers to provide independent service providers with the necessary tools and repair information. Under the new law, manufacturers are prohibited from using parts that would prevent installation of any non-manufacturer-approved replacement part or component. Also, a health plan’s coverage and payment is not allowed to require any form of prior authorization or medical documentation to complete repairs for consumer-owned complex rehabilitation technology.

Deputy Majority Whip Mia A. Ackerman (D-Dist. 45, Cumberland, Lincoln) and Sen. Pamela J. Lauria (D-Dist. 32, Barrington, Bristol, East Providence) introduced H 5619 and S 0481, directing the Department of Health to collaborate with the state’s advisory council on Alzheimer’s to distribute educational materials. With the bill’s passage, signed into law, these resources will help  educate both the public and medical providers on prevention, early detection, and management of Alzheimer’s and dementia.

Legislative Changes and Reforms

Sen. Melissa Murray (D-Dist. 24, Woonsocket, North Smithfield) and Rep. Brandon Potter (D-Dist. 16, Cranston) sponsored legislation (S 0120, H 5218) to create a three-year pilot program to remove prior authorization requirements for medically necessary care ordered by primary care providers.  Now law, the program is designed to reduce administrative delays and improve patient access to timely care.

Two bills sponsored by Sen. Pamela Lauria and Rep. Michelle McGaw (D-Dist. 71, Portsmouth, Tiverton, Little Compton) improve pharmacy flexibility. The first (H 5633, S 0483aa) allows pharmacists to dispense a one-time refill for up to 100 days if the prescriber is unavailable. The second bill (S 0482A H 5855A) simplifies the process for substituting therapeutically equivalent prescription drugs or devises. Such substitutions typically occur at the request of an insurer, and the current process requires the pharmacist to contact the patient’s prescriber for approval before filling it.

Observations from Aging Advocates:

Lori Light, the state’s Long-Term Care Ombudsman, frequently observes that facility staff accused of abuse are often terminated from one facility only to be rehired by another, with the new administrator unaware of the prior allegations. “While it is important not to penalize individuals based on unproven claims, we believe that repeated allegations involving the same staff member across multiple facilities are unlikely to be coincidental and suggest a recurring issue,” she says.

To address this, H 5303 was introduced to make the complaint histories of licensed care staff accessible to prospective employers. Light expressed disappointment that this bill did not become law and hopes to work closely with the state’s Department of Health to revise and reintroduce it next year.

“We were pleased to see that the Safe Staffing and Quality Care Act, initially passed in 2021, was amended by the state budget to allow for enforcement,” says Light. While she acknowledges that the revised law may not provide the same level of benefit to nursing home residents as originally intended, she recognizes it as a step forward.

Light also expressed disappointment that the Assisted Living Resident Empowerment Act (H5169, S484) did not pass. “Assisted living facilities remain under-regulated, with fewer resident rights despite high monthly costs and regular rate increases,” she said. The unsuccessful legislative change would have strengthened resident and family councils and improved financial transparency within these facilities.

“It’s unclear why the Department of Health’s legislation (H5426, S789), which would have increased financial transparency in nursing homes and limited equity extraction, failed to advance this year, despite having the governor’s support,” says Light. She notes that this is the second year the bill has been introduced.

“With more out-of-state investor groups acquiring facilities, it is critical to ensure that public Medicaid dollars are spent on resident care, not diverted to investors,” she emphasizes, recognizing that the bill represented a modest but essential step in that direction. “We anticipate that RIDOH will reintroduce the bill next session, and we remain committed to supporting it,” she says.

Carol Anne Costa, executive director of the Senior Agenda Coalition of RI (SACRI), notes, “SACRI worked closely with many agencies and individuals in the aging network to advance our legislative agenda. Collaboration is always beneficial for passing good laws, and more importantly, it strengthens the fabric of the coalition,” she says.

Costa continues, “SACRI fully intends to resume pushing for the passage of unsuccessful legislation in the next session, including expanded accessibility in new housing, the development of more housing for older adults, nursing home patient welfare, and assisted living resident councils. Additionally, SACRI will be closely monitoring the impact of the Trump’s Reconciliation Bill on Rhode Island.”

SACRI Policy Advisor Maureen Maigret adds, “It was absolutely wonderful to see the FY 2026 bill include a provision to increase the income eligibility for the Medicare Savings Programs (MSP), which was SACRI’s top legislative priority for 2025.”

Maigret notes that SACRI has worked tirelessly since 2013 to expand the MSP program. “These efforts finally paid off, thanks to the incredible support from community partners and legislative champions, including House Speaker  K. Joseph Shekarchi (D-Dist. 23, Warwick), lead sponsors Sen. Louis DiPalma and Rep. Karen Alzate, and many legislative co-sponsors.”

“Once eligibility is increased, as called for in the budget, potentially several thousand current MSP participants will have their co-payments covered, and thousands more Medicare enrollees will no longer have to pay for their Part B premiums (currently $185/month). These savings will help pay for other basic needs, such as food,” says Maigret.

Rhode Island’s 2025 legislative session brought meaningful advances for older adults, including expanded healthcare coverage, stronger consumer protections, and new programs supporting vulnerable populations.  Despite these successes, important bills on long-term care staff accountability, assisted living oversight, and nursing home financial transparency did not pass, leaving critical issues unresolved.

Expect committed aging organizations and advocates to return next year to advance these and other unfinished legislative priorities including promoting development of accessible housing for those with mobility impairments and caregiver tax credits to help ease the financial burden on unpaid family caregivers.

For a reporting of the provisions in the FY 2026 Rhode Island budget, visit https://rinewstoday.com/house-finance-committees-fy-26-budget-boosts-support-for-older-rhode-islanders-herb-weiss/.