Attorney General Neronha announces final health care proposals of his administration

On October 29, 2026, Rhode Island Attorney General Peter F. Neronha announced two legislative and administrative proposals for state health care reform. The first proposal would reorganize existing state health and human services agencies into two cabinet-level entities: the Health Administration and Financing Agency (HAFA), consolidating regulatory functions currently distributed across the Rhode Island Department of Health, Medicaid, the Department of Behavioral Healthcare Developmental Disabilities and Hospitals, the Office of the Health Insurance Commissioner (OHIC), and HealthSource RI; and the Human Services Agency (HSA), centralizing non-health human services programs including the Department of Health and Human Services, the Office of Healthy Aging, and the Department of Children Youth and Families. The reorganization proposal also calls for creation of a new Office of Health Policy and Planning (OHPP) to conduct data collection, analysis, and strategic health policymaking independent of HAFA. The second proposal would establish a comprehensive state-run public health insurance option available on and off HealthSource RI, Rhode Island's existing insurance marketplace. The plan would be available to individuals and any employer in Rhode Island and would be administered by the State, which would define coverage scope and oversee provider networks. The Attorney General's office developed the public option proposal in collaboration with Brown University's Center for Advancing Health Policy through Research (CAHPR), which modeled effects on coverage, premiums, employer participation, and system stability, and estimated necessary funding and implementation considerations. The announcement references that more than 25% of Rhode Islanders are underinsured and that federal health care changes are projected to cause 52,000 Rhode Islanders to lose health insurance coverage. Private insurers have continued to receive OHIC approval for premium increases over the Attorney General's objections. The public option is described as designed to increase competition in insurance markets and allow the State to control health care financing directly, without altering access to Medicaid or Medicare. CAPHR also evaluated a state prescription drug purchasing pool. In 2026, the Office introduced legislation to create a state-run drug purchasing pool open to nonstate public employers, private employers, and health insurance carriers, intended to maximize drug discount value and lower costs. The Attorney General cited prior administration actions including legal action against pharmacy benefit managers, advocacy to raise Medicaid reimbursement rates for primary care, and regulations requiring pre-merger notification for certain health care transactions. Public comment on both proposals is accepted through November 30, 2026, via healthcare@riag.ri.gov.