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/.

Senior Agenda Coalition of RI pushes wealth tax to fund programs for older residents

Published in RINewsToday on June 2, 2025

With the recent passage of the House Republican budget—which cuts some programs and services for seniors, veterans, people with disabilities, and families with children—Sulma Arias, Executive Director of Chicago-based People’s Action (PA), is calling on billionaires and large corporations to finally pay their fair share of taxes.

Senator Bernie Sanders has echoed similar sentiments on the national stage, urging lawmakers to ensure that ultra-wealthy individuals and powerful corporations contribute more equitably to the nation’s economic well-being, rather than shifting the burden to everyday Americans by cutting essential services.

In Rhode Island, Democratic lawmakers are advancing legislation this session that would increase taxes on the state’s highest earners to generate vital revenue for public programs and services.

Proposed Legislation Targets Top Earners

HB 5473, introduced on February 12, 2025, by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls), was referred to the House Finance Committee. The bill proposes a 3% surtax on taxable income above $625,000—on top of the existing 5.99% rate—targeting the top 1% of Rhode Island tax filers. The surtax is projected to raise approximately $190 million annually and would affect about 5,700 of the state’s more than 500,000 filers. If enacted, the tax would apply to income earned in tax years beginning in 2026 and would not be retroactive.

As of the May 6 House Finance Committee hearing, about 140 pieces of written testimony had been submitted on HB 5473. The committee held the bill for further study, with no additional action yet taken. The proposal remains under consideration as part of ongoing budget negotiations.

A companion bill, S. 329, was introduced in the Senate by Sen. Melissa Murray (D-Dist. 24, Woonsocket, North Smithfield) and referred to the Senate Finance Committee. A hearing on the measure was held last Thursday, and the bill was also held for further study.

As the volume of testimony indicates, the battle lines are clearly drawn. Progressive groups and unions support the legislation, while businesses and business organizations, such as the Greater Providence Chamber of Commerce and the Northern Rhode Island Chamber of Commerce, have voiced strong opposition. Governor Dan McKee has not yet taken a public position on the bills.

The Pros and Cons

Supporters argue that with Rhode Island facing a $220 million budget deficit, HB 5473 and S. 329 could raise nearly $190 million annually to fund critical services, including: K-12 and higher education; health care; housing; public transportation; affordable child care; infrastructure, and programs for older adults

They contend that the proposals would bolster the state’s safety net, particularly in light of uncertain federal funding. A more progressive tax structure, they argue, would make the system fairer by reducing the burden on middle- and lower-income residents. Currently, the top 1% of Rhode Island taxpayers control a disproportionate share of the state’s wealth but, when accounting for sales and property taxes, pay a smaller share of their income than lower-income households.

Opponents, however, warn of unintended consequences. They claim the bills would drive wealthy residents and businesses out of the state, eroding the tax base.Supporters dispute this, pointing to IRS and Stanford University studies indicating that wealthy individuals typically relocate for family or climate-related reasons—not for tax considerations. States like California and New Jersey, they note, have implemented similar surtaxes without experiencing significant outmigration.

Morally, proponents argue, those with more resources have a responsibility to help those with less—especially in a post-COVID era when many low-income families continue to struggle.

Yet critics, including the Rhode Island Public Expenditure Council (RIPEC) along with the Greater Providence Chamber of Commerce, Northern Rhode Island Chamber of Commerce and businesses, warn that such a tax could signal to entrepreneurs and investors that Rhode Island is “business unfriendly.” They contend that higher income taxes might discourage business investment and hiring, harming the state’s long-term economic prospects.

Some opponents cite Connecticut’s experience in the early 2010s, when a handful of wealthy taxpayers reportedly relocated after tax hikes, resulting in noticeable revenue loss. Given that a small number of high earners contribute a significant share of state income tax revenue, even limited outmigration could have an outsized fiscal impact, critics argue.

Skeptics also question whether new revenue will be reliably dedicated to education, infrastructure, and social programs. They point out that in the past, even funds placed in restricted accounts were sometimes redirected to fill budget shortfalls.

Aging Programs and Services at a Crossroads

“Rhode Island stands at a crossroads,” warns Carol Anne Costa, Executive Director of the Senior Agenda Coalition of Rhode Island (SACRI). With a projected $220 million deficit and potential federal cuts to programs such as Medicaid, SNAP, and services provided by the Office of Healthy Aging, Costa insists that passing HB 5473 and S. 329 is essential to preserve and expand supports for older adults and people with disabilities.

“Most of our state’s older residents are not wealthy,” Costa notes, citing Census data showing that one in four older households earns less than $25,000 annually, and 45% earn less than $50,000. Only about 8% of older households earn more than $200,000.

In FY 2023, 27,535 Rhode Islanders aged 65 and older were enrolled in Medicaid, which funds the majority of long-term services not covered by Medicare. In addition, 14% of older adults in the state relied on SNAP benefits to help cover food costs.

Costa argues that revenue from the proposed surtax could ensure continued funding for these essential programs and expand the Medicare Savings Program. Such an expansion could save low-income seniors and adults with disabilities up to $185 per month in Medicare Part B premiums—money they need for food, housing, and transportation.

While critics warn of wealthy residents fleeing Rhode Island if taxes increase, Costa cites a comprehensive report by the Economic Progress Institute refuting this claim. “In fact, the data suggests the opposite,” she says. “Higher-income tax filers are moving into Rhode Island more than they are leaving.”

Costa also points to Massachusetts as a real-world example. After voters approved a 4% surtax on income over $1 million in 2022, the number of Massachusetts residents with a net worth over $1 million increased from 441,610 to 612,109 by 2024, according to an April report from the Institute for Policy Studies and the State Revenue Alliance.

Business Community Pushes Back

At the House Finance Committee hearing, Laurie White, President of the Greater Providence Chamber of Commerce, voiced strong opposition to the proposed tax.

“Our views reflect those of thousands of local businesses statewide,” she said. “Rhode Island is already in fierce competition with neighboring states to attract and retain businesses, residents, and talent.”

White warned that the surtax would send the wrong message, particularly as Rhode Island invests in high-wage sectors like life sciences and technology. “Tax burden is a key factor in business decisions, and an increase in personal income tax would significantly reduce Rhode Island’s appeal,” she stated.

House GOP Minority Leader Michael W. Chippendale (R-Dist. 40, Coventry, Foster, Gloucester) echoed White’s sentiments: “Taxing people who have worked hard and become prosperous is an insult to the American dream. We shouldn’t be punishing success—we should be creating an economic environment where everyone can thrive. Driving away high-income residents with more taxes is backward thinking.”

Chief of Staff Sue Stenhouse confirmed that the entire 10-member House Republican caucus stands united in opposition to the surtax.

The Washington, DC-based Tax Foundation also weighed in. In written testimony on S. 329, Senior Policy & Research Manager Katherine Loughead stated that if the surtax were enacted, Rhode Island would move from having the 14th-highest to the 8th-highest top marginal state income tax rate in the nation—excluding the District of Columbia. She warned that this could make Rhode Island less attractive to high-income earners than even Massachusetts.

So What’s Next?

Costa maintains that taxing the wealthiest residents may be both a necessary and viable solution to protect the state’s safety net amid budget shortfalls and looming federal cuts.

However, with HB 5473 and S. 329 still being held for further study, it remains unclear whether they will be included in the final state budget.

“As we approach the final weeks of the session, there is no shortage of meritorious proposals that affect state resources,” said House Speaker Joseph Shekarchi (D-Dist. 23, Warwick). “The uncertainty of the federal funding picture and the numerous holes in the Governor’s proposed budget complicate both balancing this year’s budget and planning for the unknown. I continue to keep many options on the table for this challenging task.”

Stay tuned—SACRI and other aging advocacy groups are watching closely to see what options will be considered by the House Speaker when he releases FY 2026 state budget to address funding for programs and services that support Rhode Island’s growing older population in this difficult fiscal year.

To read submitted emails and testimony on S. 329, go to https://www.rilegislature.gov/senators/SenateComDocs/Pages/Finance%202025.aspx.

To read written testimony submitted on HB 5473, go to https://www.rilegislature.gov/Special/comdoc/Pages/House%20Finance%202025.aspx.