Tag Archives for Medicare Part B premiums

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.

Benefits for seniors from Rhode Island’s next budget

Published in RINewsToday on June 17, 2024 

With a 35-2 vote in the Senate early on Friday the Senate gave its approval for a $13.963 billion budget for the 2025 fiscal year, comprising 13 articles that direct additional funding toward education and children, raises Medicaid reimbursement rates, health care support, and includes a $120 million affordable housing bond. The 300-page budget bill – read here, 2024-H 7225Aaa has now gone to Gov. Dan McKee, who is scheduled to sign it at an event Monday, June 17, at 11:15 a.m. in the State Room on the second floor of the State House.

Rhode Island’s FY 2025 Budget and Seniors

House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick) reeled off specifics as to how this year’s budget proposal impacts senior programs and services, noting that it aims to lower the rising housing and health care costs that impact the quality of life of older Rhode Islanders. “We have asked the voters to approve an additional $120 million in funds to increase affordable housing production. The budget accelerates a commitment to raising Medicaid reimbursement rates for services to care for our most vulnerable seniors and people living with disabilities to stabilize our health care and human service provider networks,” noted Shekarchi. 

Under the budget proposal tax relief is provided to seniors who rely on retirement income, raising the exemption to $50,000 for qualified single filers and $100,000 for joint filers. It also repeals the suspension of annual cost of living (COLA) adjustments for retirees in the state pension system who retired before 2012 and moves up the timeline for resumption of COLA for other state retirees. 

Lawmakers changed the calculation for pension benefits to base it on the highest three consecutive years of earning instead of five. Finally, the House Speaker noted that this budget fully funds Medicaid rate increases for home care and other services that help seniors age with dignity in the community and stay in their homes if they so desire, and also increases support for services provided in nursing or assisted living settings. 

Adds Senate President Dominick J. Ruggerio(D-Dist. 4, North Providence, Providence), “I am pleased that the budget will invest in many Senate priorities, particularly in the areas of health care, child care, education and providing some needed relief to retirees,” says Ruggerio. “Specifically, the budget incorporates $2.7 million for primary care provider training sites, as well as $500,000 for tuition assistance for students who enter the primary care field and remain in Rhode Island. The budget also includes funding for purchasing medical debt for pennies on the dollar,” he says. 

But how does the aging network view this spending plan? 

According to Maureen Maigret, Policy Advisor with the Senior Agenda Coalition of RI (SACRI), under the spending plan approved by the Assembly $103.2 Million in all funds was added to the Governor’s proposed budget to fully fund the social and human service provider rate increases as recommended by the state’s Office Health of Insurance Commissioner (OHIC) based on the comprehensive legislatively mandated Rate Review Study performed in 2023. According to Maigret, who served as a member of the Advisory Task Force for the Rate Study, the full funding was especially important for those older adults and persons with disabilities seeking access to home and community services. 

“Too many persons on Medicaid have been waiting three months or longer to access needed home care supports which can cause health to deteriorate or to consider nursing home placement at far more expense to the state,” Maigret said. Maigret noted the increases would raise rates for providers of home care, assisted living, shared living and adult day services – all critical to helping persons with support needs to be able to stay at home where most persons with care needs prefer to live. 

Senior Agenda Coalition has worked for many years to promote better access to home and community-based services and to advocate for better wages for the direct care workers who provide this care,” she added, noting that these individuals are usually women, mostly women of color, and for too long have been undervalued and underpaid she noted. In 2022 the SACRI advocated with the legislature to set a minimum wage of at least $17/hour; however, the budget only called for a minimum of $15/hour. With full funding for the recommended home and community care provider rates, we would like to see these essential workers get a minimum starting wage of at least $25/hour in order to recruit and retain the necessary workers. 

SACRI also successfully pushed along with other housing advocates for the addition of $20 Million more to the Housing Bond to go on the November ballot for a total of $120 Million, Maigret added, noting that the coalition continues to advocate for paying adequate attention to the housing needs of older adults in the allocation of the bond funds. “Increasing affordable housing options for this population is critical,” says Maigret, stressing that census data shows that 53% of older RI renters pay more than 30% of their income on housing and studies show that 43% of extremely low-income RI renters are seniors. In the housing space, passage of bills to streamline development of Accessory Dwelling Units (ADUs) advanced by House Speaker Shekarchi along with most of his housing package was also a major win for expanding housing options and development. 

The legislature also addressed SACRI and its advocacy partners push to increase income eligibility for the Medicare Savings Program (MSP) that helps lower-income Medicare enrollees not on Medicaid afford needed healthcare and save dollars for other needed basic needs by covering Part B premiums ($176/month in 2024) as well as required co-payments for some with very low-incomes. “The budget includes a provision requiring the state to seek federal approval to increase the eligibility for the Medicare Savings Program for “qualified individuals” (currently persons with annual income between $18,312 and $20,331) up to 185% of the federal poverty level ($27,861),” says Maigret, adding that the Coalition plans to monitor the approval process and to seek additional legislation, if needed, next Legislative session to further expand the program. Maigret says that lawmakers expanded the Temporary Caregiver Insurance Program up to 8 weeks but SACRI was disappointed that siblings and grandchildren were not added to the list of persons for whom a worker could get paid leave.

“We will continue to advocate for these additions and to increase the number of weeks of leave up to 12 which is provided by most states that have such a program,” she says. And finally, SACRI will continue to advocate for additional funding for the Office of Healthy Aging to provide each of our communities with at least $10/per person age 65 and over to help support local senior centers and programs for older adults, says Maigret, as well as increasing the income cap to $50,000 for eligibility for the state Property Tax Relief Program (called the Circuit Breaker program) that provides a tax credit or refund for older homeowners and renters and those on Social Security Disability. 

FY 2025 Budget Helps State’s Nursing Homes  

James Nyberg, Executive Director  of LeadingAgeRI is pleased with the infusion of much-needed funds in the FY 2025 Budget to help support financially-distressed nursing homes as they continue to provide quality care in a very difficult environment.  “The providers are clearly in distress and we need to avoid any further closures to ensure access to care, resident choice and well-being, and support for the workforce,” he says.  “We also are grateful that the OHIC-recommended rate increases for various programs, including assisted living and adult day services, were expedited with full implementation this October.  Assisted living providers are scheduled for a 10.8% rate increase and adult day a 19.8% increase.  This will help support our home and community-based providers and those for whom they care, says Nyberg, who serves on the Advisory Task Force for the Rate Study. Lastly,

LeadingAgeRI supports the FY 25 Budget’s increase in the housing bond to $120 million, and calls for a portion of it to be used to expand safe and affordable senior housing, the lack of which is well-documented, including a recent report by the Long-Term Care Coordinating Council. According to Nyberg, one legislative priority that remains is to establish a Medicaid rate add-on for private rooms in nursing homes, since Medicaid is the primary payer for nursing home care.  “This would be an important step in helping to support a more homelike environment and resident privacy and dignity,” he says.

“RI nursing homes have been chronically underfunded since the implementation of the reimbursement methodology over thirteen (13) years ago,” charges John E. Gage, President & CEO of the Rhode Island Health Care Association, representing 62 nursing home providers. “Cuts to the annual inflation index, failure to re-base rates every three years since, and skyrocketing costs since the beginning of the pandemic have put RI nursing facilities at significant financial risk,” he says.

“The FY ’25 Budget passed the Rhode Island General Assembly includes funding for the first-ever rebase of Medicaid Rates since the inception of the Priced Based Reimbursement System back in 2013,” says Gage, noting that this increase represents a 14.5% increase with an estimated increase in revenue of $66 million beginning October 1, 2024, based on actual expenses from the most recent Medicaid Cost Reports from 2022. 

Additionally, Gage says that the budget as passed includes $10 million in State Fiscal Recovery Fund Grants to stabilize RI’s nursing facilities from July 1, 2024, through the implementation of the new rates on October 1. 

Pension changes initiated 

“Our primary task during this past General Assembly session has been to strongly support Bill H-8193, introduced by Rep. Pat Serpa, which would see the return of the COLA which was so ruthlessly slashed away in 2011. It applied to all current and future retirees, including teachers, state workers, and some municipal employees, says Sandra Paquette, representing Advocates for COLA Restoration and Pension Reform, a non-profit representing 4,700 retirees.

However, the actual pension provision in this year’s budget provides for the restoring of a compounded COLA to those who retired prior to July 1, 2012, notes Paquette. “Initially, this was a disappointment to our organization, as we had hoped for much needed relief for all who have been so detrimentally affected by Rhode Island Retirement Security Act — creating a financial crisis in the lives of so many lifetime workers. But further thought and consideration caused us to realize that the pension benefits in this year’s budget represent a huge step in a 13 year’s duration of no progress whatsoever in alleviating the injustice, she adds.

“And we are delighted that after so many years, older persons in the state retirement system who retired prior to 2012 will finally see a COLA,” says Maigret, “This is especially important for those who do not receive Social Security benefits.”

Editor’s Note: Added comments

Union thoughts…

Jesse Martin, Executive Vice President of SEIU 1199 NE and President of Rhode Island SEIU State Council said, “For months, union members of Rhode Island SEIU State Council have been working to raise awareness of issues that matter most to working Rhode Island families and, as a result, made great strides in healthcare, wages, funding, retirement, career training and more to the benefit of all. This year’s budget contains emergency funding to keep Linn Health open until August, provides funding to paraprofessional healthcare workers to help them advance in their careers, streamlines the hiring process at DHS and DCYF in order to attract new qualified candidates and finally enables domestic workers to earn the minimum wage. We thank all our elected leaders who offered their steadfast support and prioritized the needs of working Rhode Islanders.” 

The Rhode Island SEIU State Council, which is representative of all four SEIU affiliate locals, represents a variety of workers across the state, including healthcare, Department of Children and Families, Janitorial, Family Child Care, Department of Labor and Training, Security, Workforce Development and more. Nationwide, the Service Employees International Union represents over two million members.

Kathleen Gerard, Advocates for Better Care in Rhode Island, added, “”We were very glad to see the passage of the full Medicaid reimbursement increases recommended by the OHIC this session, and will continue to advocate for measures that ensure that our public funds are put towards the public good of improved wages for direct care staff and improved care for residents.”