Here is a summary of what happened to select legislation and budget appropriations affecting children in the area of health considered in the 2008 legislative session from the 2008 Legislative Wrap-Up:

RIte Care Eligibility for Children: Eligibility for RIte Care was maintained at 250% of the federal poverty level (FPL) for children. As of June 1, 2008, RIte Care eligibility was eliminated for the grandfathered group of 2,800 children including those with legal permanent resident status for less than 5 years and undocumented children. These children had been eligible for RIte Care if they were enrolled prior to January 1, 2007. A bill that would have increased income eligibility for RIte Care from 250% FPL to 300% FPL, restored coverage to legally present immigrant children and created a RIte Care buy-in for children in families with income above 300% FPL was not enacted. Other legislation that would have provided RIte Care eligibility to undocumented and legally present immigrant children and legally present immigrant parents also did not pass.

RIte Care for children with special health care needs (receiving SSI or coverage through Katie Beckett eligibility), children in substitute care and children with adoption subsidies: Children in these eligibility categories will now be required to enroll in a RIte Care managed care plan. Previously, enrollment in managed care was an option. Children whose parents have employer-sponsored coverage will not be enrolled in managed care but will receive "wrap around" coverage for services.

RIte Care for Parents of Eligible Children: Parent eligibility for RIte Care was reduced from 185% FPL to 175% FPL, except for pregnant or post-partum women. About 1,000 parents previously eligible will lose coverage. RIte Care coverage for 6,400 parents between 133% FPL and 175% FPL was maintained.

RIte Care Premiums: A $45 monthly RIte Care premium for families with incomes between 133% FPL and 150% FPL was approved, as was an increase in premiums currently paid by families between 150% and 250% FPL from 3% to 5% of income. Premiums will now range from $45 to $114 per month per family depending on family income.

RIte Care Benefits: A generic drug program was approved for all individuals enrolled in RIte Care, with the exception of children with special health care needs and children in substitute care. Under this program, only generic drugs will be allowed, with the exception of limited brand drug coverage for certain therapeutic classes, as approved by the RI Department of Human Services.

Community Health Center Funding for the Uninsured: $1.2 million was appropriated in the FY 2009 budget to support additional medical services that will be provided to uninsured people at the state’s 12 community health centers. There is a potential increase in uninsured patients seeking medical care at the community health centers due to the elimination of RIte Care benefits for the grandfathered group of children including legal permanent residents with less than five years of legal resident status and undocumented children.

Hospital Uncompensated Care: $9 million was appropriated in the FY 2009 budget for expected increases in hospital costs for uncompensated care provided to individuals without adequate health insurance coverage.

Health Insurance for Child Care Providers: Access to health insurance assistance for child care providers caring for state subsidized children was eliminated as of July 1, 2008. Previously, eligible family-based child care providers were able to enroll in RIte Care and centerbased providers received an $85 monthly payment per employee toward the purchase of commercial insurance.

Global Medicaid Waiver: The General Assembly authorized the Executive Office of Health & Human Services and the RI Department of Human Services to seek a Global Medicaid Waiver from the Centers for Medicare & Medicaid Services (CMS). The Global Medicaid Waiver would include all Medicaid populations and services in one waiver, ending the existing RIte Care waiver, long-term care waivers and other separate waivers. The new waiver would provide a fixed amount of federal funds over the 5-year term of the waiver, instead of the existing federal match rate for each state dollar invested in Medicaid. The waiver would allow the state to charge co-pays to children and parents enrolled in RIte Care for brand name medications and emergency room visits. The application for the waiver is expected to be submitted to CMS in August 2008. The General Assembly reserved the right to revoke the authority to implement the global waiver if the terms and conditions negotiated with CMS are not adequate. October 1, 2008 is the target date for implementation of the waiver, pending approval by CMS.

Bills Tracked in the 2008 Session of the Rhode Island General Assembly:

HEALTH INSURANCE COVERAGE

S-2220
Introduced by: Senators Pichardo, Perry, Ciccone, Metts, Miller
AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- MEDICAL ASSISTANCE
Summary: This act would provide health insurance coverage to U.S. permanent resident children and parents/also provide benefits to children ineligible for federal medical assistance due to citizenship or alien age requirements.

Action:
02/06/2008 Introduced, referred to Senate Finance

S-2854
Introduced by Senators: Paiva-Weed, Perry, Goodwin, Gibbs, Miller
ENTITLED, AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- HEALTH CARE FOR CHILDREN AND PREGNANT WOMEN
Summary: Amend the RIte Track by increasing the qualifying family income levels from 250% to 300% of the federal poverty level/adding to those qualified to receive benefits under the program noncitizen children who are lawfully residing in the US)

Action:
03/12/2008 Introduced, referred to Senate Finance

H-7875
Introduced by: Representatives Diaz, Segal, Almeida, Slater, Ajello
AN ACT RELATING TO HUMAN SERVICES – HEALTH INSURANCE
Summary: This act would provide health insurance to children ineligible for federal medical assistance due to citizenship or alien requirements and to resident parents or caretaker relatives of these children.

Action:
02/26/2008 Introduced, referred to House Finance
04/23/2008 Scheduled for hearing and/or consideration
04/23/2008 Committee recommended measure be held for further study

HEALTHY RHODE ISLAND REFORM ACT OF 2008

In February, 2008, Lieutenant Governor Elizabeth Roberts introduced a comprehensive health care reform package called the "Healthy Rhode Island Reform Act of 2008," which includes the bills listed below. S-2484 SUB B as amended, H-7352 SUB A as ameded (Lieutenant Governor-Part I) Introduced by: Senators Pichardo, Jabour, Gallo, Perry, Paiva Weed and Representatives Gemma, Fox, Church, Rice, Schadone AN ACT RELATING TO THE HEALTH AND SAFETY - HEALTHY RHODE ISLAND REFORM ACT OF 2008 Summary: This act would establish the healthy Rhode Island strategic plan and chronic care management program. Action: S-2484 SUB Baa: 02/13/2008 Introduced, referred to Senate Health and Human Services 02/27/2008 Scheduled for hearing 02/27/2008 Committee heard 05/21/2008 Scheduled for consideration 05/21/2008 Committee recommends passage of Sub A 05/28/08 Placed on Senate Calendar 06/03/2008 Senate passed Sub A as amended (floor amendment) 06/04/2008 Referred to House H.E.W. 06/17/2008 Scheduled for hearing and/or consideration 06/17/2008 Committee recommends passage of Sub B 06/17/2008 Placed on House Calendar 06/19/2008 House passed Sub B as amended (floor amendment) 06/20/2008 Placed on Senate Calendar 06/21/2008 Senate passed Sub B as amended in concurrence 06/21/2008 Transmitted to Governor 06/30/2008 Effective without Governor's signature H-7352 SUB Aaa: 02/05/2008 Introduced, referred to House H.E.W 04/02/2008 Scheduled for hearing and/or consideration 04/02/2008 Committee recommended measure be held for further study 06/17/2008 Scheduled for hearing and/or consideration 06/17/2008 Committee recommends passage of Sub A 06/17/2008 Placed on House Calendar 06/19/2008 House passed Sub A as amended (floor amendment) 06/20/2008 Placed on Senate Calendar 06/20/2008 Senate passed Sub A as amended in concurrence 06/27/2008 Transmitted to Governor H-7445, S-2809 (Lieutenant Governor-Part II) Introduced by: Representatives Church, Naughton, Dennigan, Coderre E, Slater and Senators Sosnowski, Perry, Miller, Sheehan, Gibbs AN ACT RELATING TO PUBLIC OFFICERS AND EMPLOYEES - - INSURANCE BENEFITS Summary: This act would require that any health care plan provided to state employees must require the employees to designate a primary care physician. Action: H-7445 02/13/2008 Introduced, referred to House Finance S-2809 03/05/2008 Introduced, referred to Senate Health and Human Services 03/12/2008 Scheduled for hearing 03/12/2008 Committee Continued 03/19/2008 Scheduled for hearing 03/19/2008 Committee recommended measure be held for further study S-2481 SUB B, H-7465 SUB A (Lieutenant Governor-Part III) Introduced by: Senators Levesque C, Perry, Gibbs, Sosnowski, Gallo and Representatives McNamara, Lewiss, Naughton AN ACT RELATING TO HEALTH AND SAFETY -- HEALTH CARE QUALITY PROGRAM Summary: This act would create a health care quality and value database. Action: S-2481 SUB B: 02/13/2008 Introduced, referred to Senate Health and Human Services 02/27/2008 Scheduled for hearing 02/27/2008 Committee heard 04/23/2008 Scheduled for hearing and/or consideration 04/23/2008 Scheduled for consideration 04/23/2008 Committee recommends passage of Sub A 04/30/2008 Scheduled for consideration 04/30/2008 Committee recommends passage of Sub A as amended 05/06/2008 Placed on Senate Calendar 05/15/2008 Senate passed Sub A as amended (floor amendment) 05/20/2008 Referred to House Finance 06/17/2008 Scheduled for hearing and/or consideration 06/17/2008 Committee recommends passage of Sub B 06/17/2008 Placed on House Calendar 06/19/2008 House passed Sub B 06/21/2008 Placed on the Senate Consent Calendar 06/21/2008 Senate passed Sub B in concurrence 06/21/2008 Transmitted to Governor 06/30/2008 Effective without Governor's signature 7465 SUB A: 02/13/2008 Introduced, referred to House H.E.W. 03/19/2008 Committee transferred to House Finance 06/10/2008 Scheduled for hearing and/or consideration 06/10/2008 Committee heard 06/17/2008 Scheduled for hearing and/or consideration 06/17/2008 Committee recommends passage of Sub A 06/17/2008 Placed on House Calendar 06/19/2008 House passed Sub A 06/20/2008 Placed on Senate Calendar 06/20/2008 Senate passed Sub A in concurrence 07/04/2008 Effective without Governor's signature S-2472, H-7910 (Lieutenant Governor-Part IV) Introduced by: Senators Miller, Paiva Weed, Perry, Gibbs, Felag and Representatives: Fox, Slater, Rice, Ferri, Corvese AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT Summary: This act would create the Rhode Island Health Insurance Access Hub Act of 2008 to facilitate the purchase of affordable health care to eligible persons and groups Action: S-2472 02/13/2008 Introduced, referred to Senate Health and Human Services 03/05/2008 Scheduled for hearing 03/05/2008 Committee continued 03/12/2008 Scheduled for hearing 03/12/2008 Committee continued 03/19/2008 Scheduled for hearing 03/19/2008 Committee recommended measure be held for further study 06/18/2008 Scheduled for hearing and/or consideration 06/18/2008 Committee recommended measure be held for further study H-7910 02/26/2008 Introduced, referred to House Corporations 03/11/2008 Scheduled for hearing and/or consideration 03/11/2008 Committee recommended measure be held for further study S-2686 (Lieutenant Governor-Part V) Introduced by: Senators Perry, Tassoni, Pichardo, Sosnowski, Miller AN ACT RELATING TO TAXATION -- THE HEALTHY RHODE ISLAND REFORM ACT OF 2008--PART V--EXPANDING HEALTHCARE COVERAGE Summary: This act would mandate that individuals over 18 years of age whose AGI is 400% of the federal poverty level obtain and maintain health coverage and indicate so on his/her income tax. Action: 02/26/2008 Introduced, referred to Senate Health and Human Services 03/05/2008 Scheduled for hearing 03/05/2008 Committee continued 03/12/2008 Scheduled for hearing 03/12/2008 Committee continued 03/19/2008 Scheduled for hearing 03/19/2008 Committee recommended measure be held for further study S-2684, H-7399 (Lieutenant Governor-Part VI) Introduced by: Senators Perry, Miller, Sosnowski, Pichardo, Goodwin and Representatives: Coderre E, Naughton, Kennedy, McNamara AN ACT RELATING TO INSURANCE - ACCIDENT AND SICKNESS INSURANCE POLICIES Summary: This act would amend the definition of a dependent on health insurance polices. It would not require that a child between 19 and 25 be a student to be considered a dependent. Action: S-2684 02/26/2008 Introduced, referred to Senate Health and Human Services 03/05/2008 Scheduled for hearing 03/05/2008 Committee continued 03/12/2008 Scheduled for hearing 03/12/2008 Committee continued 03/19/2008 Scheduled for hearing 03/19/2008 Committee recommended measure be held for further study H-7399 02/12/2008 Introduced, referred to House Corporations 03/11/2008 Scheduled for hearing and/or consideration 03/11/2008 Committee recommended measure be held for further study H-7493 Sub B, S-2286 Sub B (Lieutenant Governor-Part VII) Introduced by: Representatives Ferri, Lewiss, Baldelli-Hunt, Malik, Winfield and Senators Sheehan, Perry, Sosnowski, Paiva-Weed, Walaska AN ACT RELATING TO INSURANCE -- HEALTH INSURANCE MARKET EXPANSION Summary: This act would establish a regional health insurance market between Rhode Island, Massachusetts and Connecticut. Action: H-7493 Sub B: 02/13/2008 Introduced, referred to House Corporations 03/11/2008 Scheduled for hearing and/or consideration 03/11/2008 Committee recommended measure held for further study 04/23/2008 Scheduled for hearing and/or consideration 04/23/2008 Placed on House Calendar 05/08/2008 House passed Sub A as amended (floor amendment) 05/15/2008 Referred to Senate Health and Human Services 06/18/2008 Scheduled for hearing and/or consideration 06/18/2008 Committee recommends passage of Sub B 06/18/2008 Placed on Senate Calendar 06/19/2008 Senate passed Sub B 06/21/2008 House passed Sub B in concurrence 06/26/2008 Transmitted to Governor 07/01/2008 Signed by Governor S-2286 Sub B: 02/07/2008 Introduced, referred to Senate Health and Human Services 03/05/2008 Scheduled for hearing 03/05/2008 Committee heard 04/23/2008 Scheduled for hearing and/or consideration 04/23/2008 Scheduled for consideration 04/23/2008 Committee recommends passage of Sub A 04/29/2008 Placed on Senate Calendar 05/06/2008 Senate passed Sub A 05/07/2008 Referred to House Corporations 06/03/2008 Scheduled for hearing and/or consideration 06/03/2008 Committee recommended measure be held for further study 06/10/2008 Scheduled for hearing and/or consideration 06/10/2008 Committee recommends passage of Sub B 06/10/2008 Placed on House Calendar 06/12/2008 House passed Sub B 06/21/2008 Placed on the Senate Consent Calendar 06/21/2008 Senate passed Sub B in concurrence 06/21/2008 Transmitted to Governor 06/26/2008 Signed by Governor S-2222, House Resolution 7466 (Lieutenant Governor-Part VIII) Introduced by: Senators Tassoni, Perry, Paiva Weed, Montalbano J and Representatives Lewiss, Church, Ferri, Gemma, Slater JOINT RESOLUTION CREATING A JOINT TASK FORCE TO STUDY ALL ASPECTS OF HEALTH CARE REFORM RELATING TO THE HEALTHY RHODE ISLAND REFORM ACT OF 2008 - PART VIII Action: S-2222 02/06/2008 Introduced, referred to Senate Health and Human Services 03/05/2008 Scheduled for hearing 03/05/2008 Committee heard 03/19/2008 Scheduled for hearing 03/19/2008 Committee recommends passage 03/25/2008 Placed on Senate Calendar 03/27/2008 Senate Read and Passed 04/01/2008 Referred to House H.E.W. 05/14/2008 Scheduled for hearing and/or consideration 05/14/2008 Committee recommends passage in concurrence 05/14/2008 Placed on House Calendar 05/20/2008 House passed in concurrence 06/30/2008 Transmitted to Governor H-7466 02/13/2008 Introduced, referred to House H.E.W. 03/26/2008 Scheduled for hearing and/or consideration 03/26/2008 Committee recommended measure be held for further study 04/09/2008 Scheduled for hearing and/or consideration 04/09/2008 Committee recommends passage 04/09/2008 Placed on House Calendar 04/30/2008 House read and passed 06/10/2008 Referred to Senate Constitutional and Regulatory Issues 06/18/2008 Scheduled for hearing and/or consideration 06/18/2008 Committee recommends passage in concurrence 06/21/2008 Placed on the Senate Consent Calendar 06/21/2008 Senate passed in concurrence 06/27/2008 Transmitted to Governor

HEALTH ISSUES

S-2283 SUB Aaa, H-7467 SUB B
Introduced by: Senators Perry, Moura, Sosnowski, Gallo, Pichardo
Representatives Naughton, McNamara, Coderre E, Dennigan
AN ACT RELATING TO HEALTH AND SAFETY - BREASTFEEDING - PROMOTES THE INTERESTS OF MATERNAL AND CHILD HEALTH
Summary: This act would allow a woman to feed her child by bottle or breast in any place open to the public and would allow her a private cause of action for denial of this right.

Action:
S-2283 SUB A as Amended
02/07/2008 Introduced, referred to Senate Health and Human Services
02/13/2008 Scheduled for hearing and/or consideration
02/13/2008 Committee continued
03/05/2008 Scheduled for hearing
03/05/2008 Committee heard
04/09/2008 Scheduled for consideration
04/09/2008 Committee continued
05/07/2008 Scheduled for hearing and/or consideration
05/07/2008 Committee recommends passage of Sub A as amended
05/20/2008 Placed on Senate Calendar
05/29/2008 Senate passed Sub A as amended (floor amendment)
06/03/2008 Referred to House H.E.W.
06/11/2008 Scheduled for hearing and/or consideration
06/11/2008 Committee recommends passage of Sub A as amended in concurrence
06/11/2008 Placed on House Calendar
06/17/2008 House passed Sub A as amended in concurrence
06/30/2008 Transmitted to Governor

H-7467 SUB B
02/13/2008 Introduced, referred to House H.E.W.
03/26/2008 Scheduled for hearing and/or consideration
03/26/2008 Committee recommended measure be held for further study
04/09/2008 Scheduled for hearing and/or consideration
04/09/2008 Committee recommends passage of Sub A
04/09/2008 Placed on House Calendar
05/06/2008 House passed Sub A
05/07/2008 Referred to Senate Health and Human Services
05/28/2008 Scheduled for hearing and/or consideration
05/28/2008 Committee recommends passage of Sub B
05/29/2008 Placed on Senate Calendar
06/04/2008 Senate passed Sub B
06/21/2008 House passed Sub B in concurrence
06/26/2008 Transmitted to Governor