Attorney General Neronha announces final health care proposals of his administration
Published on Thursday, October 29, 2026
Attorney General Peter F. Neronha today announced two health care-related proposals aimed at providing long-term solutions for stabilizing Rhode Island’s health care system. The proposals include restructuring state health care oversight agencies and introducing a state-run comprehensive public health insurance option.
“As my time as Attorney General winds down, and I reflect on the Office’s accomplishments during my tenure, health care advocacy sits near the top of the list,” said Attorney General Neronha. “When I first ran for Office, I didn’t necessarily consider the profound need for health care reform in Rhode Island, and the impact my Office could have in both advocating for and helping to implement real change. I’m incredibly proud of our work in this space, while acutely aware that so much more work needs to be done to right the ship. Families are struggling to make ends meet; the cost of goods like groceries, gas, housing, and energy continues to climb while wages stay largely stagnant. If we don’t treat our health care system failures as an emergency, in particular rising insurance and out-of-pocket costs, and primary care shortages, we will have failed our residents. As I’ve said many times before, only bold and strategic action will be successful in fixing our health care system.
“To that end, today my Office is announcing two major health care reform proposals. The first would reorganize the existing health and human services agencies under a more responsive oversight structure, while creating a new independent agency which will focus on the collection of health data to inform health care strategy and bring real expertise to drive long-term policy strategy and development. The second proposal would create a comprehensive public health insurance option, available on and off the State’s insurance marketplace, to offer a state-managed plan, enhancing the State’s ability to control costs and offer a stable source of high-quality coverage that mirrors the state employee health plan.
“I understand some will scoff at the size and scope of these proposals. But just because something is hard does not mean we should run away from it. These proposals would help drastically reduce and stabilize health care costs for Rhode Islanders in the long run while filling health data and strategy voids which exist within our system to the detriment of our residents. We must decide if we want to continue making reactive, piecemeal policy decisions without any real strategy and data to support them. We must decide if we want to invest in a public option that will increase competition in our insurance markets and allow the state to control costs, or keep subsidizing continued premium increases with no measurable improvements in care.
“I urge state leaders to consider these proposals and work to implement them after I leave office. Terms in public office come to an end, but the work continues, and I would be more than happy to discuss these proposals with any interested parties.”
This announcement follows significant actions taken over the past two years by the Office to strengthen the state’s health care landscape, including legal action against pharmacy benefit managers (PBMs), successful advocacy to significantly raise Medicaid reimbursement rates for primary care, and regulations requiring pre-merger notification for certain health care transactions, among other initiatives. In-depth information about the Office’s initiatives, and more, can be found on our dedicated health care website.
Agency Reorganization
This proposal would reorganize the existing health and human services agencies to centralize all agencies with a role in health care regulation under a more responsive oversight structure. This proposal would also create a new agency to enhance the level of health data and policy expertise available to drive long-term policy development.
The proposed agency reorganization builds on recent calls for administrative change and is informed by the challenges the state has faced, ranging from the increasing role of private equity in health care to the shortage of primary care providers throughout the state.
Under this proposal, Rhode Island’s existing health and human services agencies would be restructured into two cabinet-level agencies – the Health Administration and Financing Agency (HAFA) and the Human Services Agency (HSA). HAFA would consolidate existing health regulatory functions – currently scattered across multiple cabinet-level agencies – to focus on technical operations and oversight of providers, insurers, and patient care. This includes the functions currently exercised by the Rhode Island Department of Health, Medicaid, the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH), the Office of the Health Insurance Commissioner (OHIC), and HealthSource RI. HSA would serve as the centralized executive agency responsible for the administration of all non-health-related human services programs. This includes the functions currently exercised by the Department of Health and Human Services, the Office of Healthy Aging, and the Department of Children, Youth, and Families (DCYF).
Modeled after similar agencies in other states, the new Office of Health Policy and Planning (OHPP) would work alongside HAFA but would steer strategic health policymaking in the executive branch and coordinate data collection and analysis, two areas where state leaders currently lack resources and, more importantly, sustained focus. OHPP’s objective and neutral analysis of real-time data would assist state leaders in addressing problems before they become crises and align policy decisions with better health outcomes for Rhode Islanders.
A Public Option
Our proposal, in collaboration with researchers from Brown University’s Center for Advancing Health Policy through Research (CAHPR), would create a comprehensive public health insurance option to offer a state-regulated plan on the existing health insurance marketplace, HealthSource RI.
This proposal aims to address the escalating crisis in Rhode Islanders’ access to health insurance and care. More than 25% of Rhode Islanders are underinsured, meaning that their current insurance fails to protect them from onerous medical expenses. At the same time, federal health care changes are expected to cause 52,000 Rhode Islanders to lose health insurance coverage. Meanwhile, private health insurers have continued to secure approval from the Office of the Health Insurance Commissioner for steep annual premium increases, despite Attorney General Neronha’s repeated objections that these increases are unaffordable for Rhode Islanders. Those increases fall disproportionally on individuals and small businesses.
The Office’s collaboration with CAHPR examines potential policy options for state-based health care reform; estimates necessary funding; models potential effects on coverage, premiums, employer participation, and system stability; and identifies implementation considerations for policymakers.
The plan provided under the public option would be available to individuals and for adoption by any employer in Rhode Island. Through administering the public option plan, the State would define the scope of the coverage and oversee provider networks. Introducing a public option would not change access to or availability of Medicaid and Medicare, nor would it affect these programs. At a time when Rhode Islanders are struggling to afford and access health care, the public option would provide a permanent vehicle for the State to directly control health care financing in the state and ensure that insurance is tailored to meet the needs of Rhode Islanders.
CAHPR also evaluated the effects of introducing a state prescription drug purchasing pool, a tool for using the State’s purchasing power to lower drug costs. In 2026, the Office introduced legislation that would create a state-run drug purchasing pool, available for participation by nonstate public employers, private employers, and health insurance carriers, to maximize the value of drug discounts available to participants, aiming to lower costs for all.
For more information on these and other initiatives, please visit our website. For each of these proposals, our website includes:
- A one-page informational sheet
- An executive summary
- The full proposals
- Press conference slides
The public may submit written comment on the proposals to healthcare@riag.ri.gov until November 30, 2026. Please include “Public Comment” in the subject line to ensure your comments are considered.
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