Rhode Island Faces Major Health Insurance Premium Hikes After Federal Subsidy Expiration

Rhode Island is facing significant health insurance premium increases for approximately 45,000 individuals and families who purchase coverage through HealthSource RI, the state's individual marketplace under the Affordable Care Act. These enrollees include small business owners, self-employed individuals, and pre-Medicare retirees, many of whom are not eligible for Medicare or Medicaid and do not receive employer-sponsored insurance. The average premium increase for this population is estimated at 85%, with some facing premium costs that consume over a third of their income.

This surge is largely attributed to the expiration of the Enhanced Premium Tax Credit (EPTC) at the federal level as of December 31, 2025, which previously subsidized premiums for eligible individuals. The removal of these tax credits is projected to reduce enrollment by more than 25%, impacting over 11,000 Rhode Islanders. These changes contribute to the risk of a less healthy insurance pool and increased reliance on emergency care, which could drive costs higher across the system. Rhode Island had made significant strides in achieving over 97% insurance coverage, aided by policies including the EPTC. However, the withdrawal of federal support presents a $40 million funding gap for the state and threatens affordability for working-class families who fall between Medicaid eligibility and employer-based coverage.

State officials and advocates are calling for Congress to renew the EPTC through pending legislation, emphasizing the need to prevent increased uninsured rates and financial strain on affected households. The situation highlights the interplay between federal policy decisions, state insurance markets, and public health outcomes, with implications for coverage stability and financial accessibility in Rhode Island's health insurance landscape.