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Administration proposes state affordability program to replace part of expired enhanced APTCs for low-income marketplace enrollees
Summary
HealthSource RI projected large enrollment losses after enhanced federal premium tax credits expired; the governor proposes a state affordability program targeted at households under 200% FPL (half-year $9.5M FY27, $20M annualized) to reduce uninsured risk and stabilize the individual market.
HealthSource RI director Lindsey Lang told the House Finance Committee that the expiration of the enhanced federal advanced premium tax credits (APTCs) reduced roughly $60 million a year of federal support to Rhode Island and drove marketplace enrollment declines and a shift to lower-tier plans.
"The expiration of the enhanced portion of the tax credits represents about $60,000,000 annually that's no longer coming into our state to help with affordability," Lang said, adding that marketplace enrollment fell by nearly 10,000 people compared with 2025 and that lower-income households have seen the biggest percentage declines.
Lang described the governor's Rhode Island Marketplace affordability program (referred to in testimony as "Bridal") to target households under 200% of the federal poverty level. The administration framed the program as a partial state backfill designed to restore purchasing power for the most affected households while recognizing the state's limited fiscal capacity.
"This program would bring their monthly cost back to what they would have been before the enhanced federal tax credit support expired," Lang said, estimating the program could reverse roughly half of the anticipated coverage losses for the targeted group (about 6,500 people) at about a third of the lost federal cost.
Committee members asked about timing and mechanics. Lang said a special-enrollment period could be opened if a budget passes and funds are appropriated, but the operations and eligibility changes require system modifications, which the agency estimated could be staged so a new benefit would be ready for a fall open-enrollment rollout if the budget is passed by July.
Members from across the floor pressed why the proposal targets households below 200% FPL rather than a broader subsidy; administration officials said they prioritized the greatest percentage impacts on affordability given limited state dollars. Several witnesses and advocates in public testimony supported the targeted subsidy but some urged a full replacement of the expired enhanced credits, noting the broader market-wide effects if large numbers of people drop coverage.
The committee did not immediately act on the proposal and asked administration staff for technical drafting clarifications about how the law's subject-to-appropriation language would be applied operationally.
