Bill Sponsors
Lauria, Lawson, DiMario, Murray, Valverde, Kallman, Ujifusa, Pearson, Zurier, and Urso
Committee
Senate Health & Human Services
Summary
Select
This bill establishes the "Catastrophic Illness in Children Relief Fund" to assist Rhode Island families with children (21 years of age and younger) facing high medical expenses not covered by insurance or other state/federal programs. The fund is financed by an annual surcharge of $1.50 per employee levied on employers subject to employment security laws. A newly created commission will administer the fund, establishing eligibility based on a family's income relative to their medical expenses. The commission will manage reimbursements to families for costs such as hospital care, drugs, and physician services.
Sponsor
Analysis
Pros for Progressives
- Establishes a vital financial safety net for families, preventing bankruptcy and poverty caused by the exorbitant costs of healthcare for children with severe medical conditions.
- Ensures that access to life-saving medical treatment, nursing care, and pharmaceuticals is available to children regardless of the limitations of private insurance coverage or gaps in existing government programs.
- Utilizes a corporate surcharge to fund the program, ensuring that the business community contributes to the social welfare and health of the state's future workforce rather than placing the burden on individual taxpayers.
Cons for Progressives
- The funding mechanism is a flat fee per employee rather than a progressive tax on corporate profits, which may disproportionately burden small businesses and non-profits compared to large corporations.
- Relies on means-testing and complex eligibility calculations regarding income percentages, which creates bureaucratic hurdles that may discourage the most vulnerable and educationally disadvantaged families from applying.
- Acts as a stop-gap measure that subsidizes the failures of the private health insurance industry rather than enacting systemic reform to control healthcare prices or guarantee universal coverage.
Pros for Conservatives
- Supports the traditional family unit by providing a safety net that keeps families financially solvent and independent during medical crises, potentially reducing long-term reliance on other welfare programs.
- Establishes the program as a revolving fund with a specific, dedicated revenue stream, theoretically preventing the program from drawing from the state's general tax revenue or increasing the general deficit.
- Includes provisions for the state to recover funds if a family later receives a legal settlement or judgment regarding the illness, demonstrating a commitment to fiscal responsibility and preventing "double dipping."
Cons for Conservatives
- Imposes a new financial mandate on private businesses by levying a surcharge on every employee, effectively increasing the cost of hiring labor and interfering with the free market.
- Expands the size and scope of state government by creating a new commission with appointed members and administrative staff, increasing bureaucracy and government oversight.
- Redistributes private capital from business owners to cover individual private expenses, moving the state closer to socialized medicine and reducing the incentive for individuals to carry comprehensive private catastrophic insurance.
Constitutional Concerns
None Likely
Impact Overview
Groups Affected
- Families with sick children
- Employers subject to employment security laws
- Children under age 21
- Department of Labor and Training
- Healthcare providers
Towns Affected
All
Cost to Taxpayers
Employers: $1.50/yr per employee
Revenue Generated
Employers: $1.50/yr per employee
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Regulatory
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Clarity of Bill Language
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Environmental Impact
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Bill Status
Current Status
Held
Comm Passed
Floor Passed
Law
History
• 01/16/2026 Introduced, referred to Senate Health and Human Services
Bill Text
SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby amended by adding thereto the following chapter: CHAPTER 1.12 CATASTROPHIC ILLNESS IN CHILDREN RELIEF FUND
23-1.12-1. Definitions.
When used in this chapter, unless the context requires otherwise:
(1) "Catastrophic illness" means any illness or condition the medical expenses of which are not covered by any other state or federal program or any insurance contract and exceed ten percent (10%) of the first one hundred thousand dollars ($100,000) of annual income of a family plus fifteen percent (15%) of the excess income over one hundred thousand dollars ($100,000).
(2) "Child" means a person twenty-one (21) years of age and younger.
(3) "Commission" means the catastrophic illness in children relief fund commission established pursuant to § 23-1.12-3.
(4) "Family" means a child and the child's parent, parents or legal guardian, as the case may be, who is legally responsible for the child's medical expenses.
(5) "Fund" means the catastrophic illness in children relief fund established pursuant to § 23-1.12-2.
(6) "Income" means all money received for work or in exchange for labor or goods or received through investments.
(7) "Resident" means a person legally domiciled within the state for a period of three (3) months immediately preceding the date of application for inclusion in the program. Mere seasonal or temporary residence within the state, of whatever duration, does not constitute domicile. Absence from this state for a period of twelve (12) months or more is prima facie evidence of abandonment of domicile. The burden of establishing legal domicile within the state is upon the parent, parents or legal guardian of a child.
23-1.12-2. Catastrophic illness in children relief fund.
(a) The catastrophic illness in children relief fund is hereby established as a nonlapsing, revolving fund. The fund shall be administered by the commission, and shall be credited with monies received pursuant to § 23-1.12-10.
(b) The general treasurer shall be custodian of the fund and all disbursements from the fund shall be made by the treasurer upon vouchers signed by the chairman of the commission. The monies in the fund shall be invested and reinvested by the treasurer as are other trust funds in the custody of the general treasurer in the manner provided by law. Interest received on the monies in the fund shall be credited to the fund.
23-1.12-3. Catastrophic illness in children relief fund commission.
(a) There is hereby established in the executive department of the state government the catastrophic illness in children relief fund commission composed of nine (9) members. The commission shall consist of the director of the department of children, youth and families, the director of the department of human services, the director of the department of business regulation, the general treasurer, all of whom shall be ex officio members, and five (5) public members who are residents of this state, appointed by the governor with the advice and consent of the senate, for terms of five (5) years, two (2) of whom to be appointed after consultation with the president of the senate, with one of whom a provider of health care services to children in this state; and two (2) of whom to be appointed after consultation with the speaker of the house of representatives, with one of whom a provider of health care services to children in this state. The five (5) public members initially appointed by the governor shall serve for terms of one, two (2), three (3), four (4) and five (5) years, respectively, as designated by the governor.
(b) Each member shall hold office for the term of their appointment and until their successor has been appointed and qualified. A member of the commission is eligible for reappointment.
(c) Any vacancies in the membership of the commission occurring other than by the expiration of a term shall be filled in the same manner as the original appointment, but for the LC003655 - Page 2 of 7 unexpired term only.
(d) Each ex officio member of the commission may designate an officer or employee of the ex officio member's department to represent the member at meetings of the commission, and each designee may lawfully act on behalf of the member as the designee. Any designation shall be in writing delivered to the commission and filed with the office of the secretary of state and shall continue in effect until revoked or amended in the same manner as provided for designation.
23-1.12-4. Suspension and oaths.
Each member of the commission may be removed from office by the governor, for cause, after a public hearing and may be suspended by the governor pending the completion of the hearing. Each member of the commission before entering upon their duties shall take and subscribe to an oath to perform the duties of the office faithfully, impartially and justly to the best of the member's ability. A record of the oaths shall be filed in the office of the secretary of state.
23-1.12-5. Officers and quorum.
(a) The members shall elect a chairperson who shall serve as chief executive officer of the commission and shall be one of the public members of the commission. The commission shall by rule determine the term of office of the chairperson and chief executive officer. The members shall elect a secretary and a treasurer who need not be members of the commission and the same person may be elected to serve both as secretary and treasurer.
(b) The powers of the commission are vested in the members thereof in office from time to time and five (5) members of the commission shall constitute a quorum at any meeting thereof. Action may be taken and motions and resolutions adopted by the commission at any meeting thereof by the affirmative vote of at least five (5) members of the commission. A vacancy in the membership of the commission shall not impair the right of a quorum to exercise all the powers and perform all the duties of the commission.
(c) The members of the commission shall serve without compensation; provided, that the commission shall reimburse its members for the reasonable expenses incurred in the performance of their duties based upon the monies available in the fund.
(d) The commission shall be appointed within three (3) months after the effective date of this chapter and shall organize as soon as may be practicable after the appointment of its members.
23-1.12-6. Powers and duties.
The commission shall have, but is not limited to, the following powers and duties:
(1) Establish a program for the purposes of this chapter, administer the fund and authorize the payment or reimbursement of the medical expenses of children with catastrophic illnesses;
(2) Establish procedures for application to the program, determining the eligibility for the LC003655 - Page 3 of 7 payment or reimbursement of medical expenses for each child, and processing fund awards and appeals;
(3) Establish procedures to provide that, in the case of an illness or condition for which the family, after receiving assistance pursuant to this chapter, recovers damages for the child's medical expenses pursuant to a settlement or judgment in a legal action, the family shall reimburse the fund for the amount of assistance received, or that portion thereof covered by the amount of the damages less the expense of recovery;
(4) Establish the amount of reimbursement for the medical expenses of each child using a sliding fee scale based on a family's ability to pay for medical expenses which takes into account family size, family income and assets and family medical expenses and adjust the financial eligibility criteria established in the definition of catastrophic illness pursuant to § 23-1.12-1 based upon the monies available in the fund;
(5) Disseminate information on the fund and the program to the public;
(6) Adopt bylaws for the regulation of its affairs and the conduct of its business, adopt an official seal and alter the same at pleasure, maintain an office at the place within the state as it may designate, and sue and be sued in its own name;
(7) Appoint, retain or employ staff, experts or consultants on a contract basis or otherwise, who are deemed necessary, and employ investigators or other professionally qualified personnel as may be within the limits of funds appropriated or otherwise made available to it to accomplish its purposes;
(8) Maintain confidential records on each child who applies for assistance under the fund;
(9) Take all actions deemed necessary to implement the purposes of this chapter; and
(10) Adopt rules and regulations in accordance with chapter 35 of title 42 ("administrative procedures"), necessary to effectuate the purposes of this chapter.
23-1.12-7. Settlement of claims.
The commission is authorized to negotiate or settle a claim that the fund maintains for reimbursement against a family who has received assistance for the medical expenses of a child with a catastrophic illness pursuant to this chapter and has recovered damages in a legal action for the child's medical expenses. Money recovered pursuant to this section shall be deposited in the fund.
23-1.12-8. Eligibility.
(a) A child who is a resident of this state is eligible, through the child's parent, parents or legal guardian, to apply to the program established pursuant to § 23-1.12-6.
(b) In the event a family has more than one child with a catastrophic illness, as defined LC003655 - Page 4 of 7 pursuant to § 23-1.12-1, the commission shall waive the family responsibility, as established by rule or regulation, for the other child if the family has met the family responsibility for the first child in a state fiscal year.
23-1.12-9. Financial assistance.
Whenever a child has a catastrophic illness and is eligible for the program, the child, through the child's parent, parents or legal guardian, shall receive financial assistance from monies in the fund subject to the rules and regulations established by the commission and the availability of monies in the fund. The financial assistance shall include, but is not limited to, payments or reimbursements for the cost of medical treatment, hospital care, drugs, nursing care and physician services.
23-1.12-10. Annual surcharge per employee subject to the employer security act.
For the purpose of providing the monies necessary to establish and meet the purposes of the fund, the commission shall establish a one dollar and fifty cent ($1.50) annual surcharge per employee upon all employers who are subject to the employment security laws pursuant to chapters 42, 43 and 44 of title 28. The surcharge shall be collected by the director of the department of labor and training and paid over to the general treasurer for deposit in the fund annually as provided by the commission.
23-1.12-11. Rules and regulations.
The general treasurer shall adopt rules and regulations establishing procedures for the collection of the surcharge contained in § 23-1.12-10.
23-1.12-12. Annual reports.
(a) The commission shall report annually to the governor and to the committees of the senate and house of representatives with responsibility for issues affecting children, health and human services on the status of the program. The report shall include the following information:
(1) The number of participants in the program;
(2) Average expenditures per participant;
(3) The nature and type of catastrophic illnesses for which the fund provided financial assistance; and
(4) The average income and expenditures of families who received financial assistance under the program.
(b) The commission also may make recommendations for changes in the law and regulations governing the fund to the general assembly as a portion of its report. LC003655 - Page 5 of 7
SECTION 2. This act shall take effect upon passage.
23-1.12-1. Definitions.
When used in this chapter, unless the context requires otherwise:
(1) "Catastrophic illness" means any illness or condition the medical expenses of which are not covered by any other state or federal program or any insurance contract and exceed ten percent (10%) of the first one hundred thousand dollars ($100,000) of annual income of a family plus fifteen percent (15%) of the excess income over one hundred thousand dollars ($100,000).
(2) "Child" means a person twenty-one (21) years of age and younger.
(3) "Commission" means the catastrophic illness in children relief fund commission established pursuant to § 23-1.12-3.
(4) "Family" means a child and the child's parent, parents or legal guardian, as the case may be, who is legally responsible for the child's medical expenses.
(5) "Fund" means the catastrophic illness in children relief fund established pursuant to § 23-1.12-2.
(6) "Income" means all money received for work or in exchange for labor or goods or received through investments.
(7) "Resident" means a person legally domiciled within the state for a period of three (3) months immediately preceding the date of application for inclusion in the program. Mere seasonal or temporary residence within the state, of whatever duration, does not constitute domicile. Absence from this state for a period of twelve (12) months or more is prima facie evidence of abandonment of domicile. The burden of establishing legal domicile within the state is upon the parent, parents or legal guardian of a child.
23-1.12-2. Catastrophic illness in children relief fund.
(a) The catastrophic illness in children relief fund is hereby established as a nonlapsing, revolving fund. The fund shall be administered by the commission, and shall be credited with monies received pursuant to § 23-1.12-10.
(b) The general treasurer shall be custodian of the fund and all disbursements from the fund shall be made by the treasurer upon vouchers signed by the chairman of the commission. The monies in the fund shall be invested and reinvested by the treasurer as are other trust funds in the custody of the general treasurer in the manner provided by law. Interest received on the monies in the fund shall be credited to the fund.
23-1.12-3. Catastrophic illness in children relief fund commission.
(a) There is hereby established in the executive department of the state government the catastrophic illness in children relief fund commission composed of nine (9) members. The commission shall consist of the director of the department of children, youth and families, the director of the department of human services, the director of the department of business regulation, the general treasurer, all of whom shall be ex officio members, and five (5) public members who are residents of this state, appointed by the governor with the advice and consent of the senate, for terms of five (5) years, two (2) of whom to be appointed after consultation with the president of the senate, with one of whom a provider of health care services to children in this state; and two (2) of whom to be appointed after consultation with the speaker of the house of representatives, with one of whom a provider of health care services to children in this state. The five (5) public members initially appointed by the governor shall serve for terms of one, two (2), three (3), four (4) and five (5) years, respectively, as designated by the governor.
(b) Each member shall hold office for the term of their appointment and until their successor has been appointed and qualified. A member of the commission is eligible for reappointment.
(c) Any vacancies in the membership of the commission occurring other than by the expiration of a term shall be filled in the same manner as the original appointment, but for the LC003655 - Page 2 of 7 unexpired term only.
(d) Each ex officio member of the commission may designate an officer or employee of the ex officio member's department to represent the member at meetings of the commission, and each designee may lawfully act on behalf of the member as the designee. Any designation shall be in writing delivered to the commission and filed with the office of the secretary of state and shall continue in effect until revoked or amended in the same manner as provided for designation.
23-1.12-4. Suspension and oaths.
Each member of the commission may be removed from office by the governor, for cause, after a public hearing and may be suspended by the governor pending the completion of the hearing. Each member of the commission before entering upon their duties shall take and subscribe to an oath to perform the duties of the office faithfully, impartially and justly to the best of the member's ability. A record of the oaths shall be filed in the office of the secretary of state.
23-1.12-5. Officers and quorum.
(a) The members shall elect a chairperson who shall serve as chief executive officer of the commission and shall be one of the public members of the commission. The commission shall by rule determine the term of office of the chairperson and chief executive officer. The members shall elect a secretary and a treasurer who need not be members of the commission and the same person may be elected to serve both as secretary and treasurer.
(b) The powers of the commission are vested in the members thereof in office from time to time and five (5) members of the commission shall constitute a quorum at any meeting thereof. Action may be taken and motions and resolutions adopted by the commission at any meeting thereof by the affirmative vote of at least five (5) members of the commission. A vacancy in the membership of the commission shall not impair the right of a quorum to exercise all the powers and perform all the duties of the commission.
(c) The members of the commission shall serve without compensation; provided, that the commission shall reimburse its members for the reasonable expenses incurred in the performance of their duties based upon the monies available in the fund.
(d) The commission shall be appointed within three (3) months after the effective date of this chapter and shall organize as soon as may be practicable after the appointment of its members.
23-1.12-6. Powers and duties.
The commission shall have, but is not limited to, the following powers and duties:
(1) Establish a program for the purposes of this chapter, administer the fund and authorize the payment or reimbursement of the medical expenses of children with catastrophic illnesses;
(2) Establish procedures for application to the program, determining the eligibility for the LC003655 - Page 3 of 7 payment or reimbursement of medical expenses for each child, and processing fund awards and appeals;
(3) Establish procedures to provide that, in the case of an illness or condition for which the family, after receiving assistance pursuant to this chapter, recovers damages for the child's medical expenses pursuant to a settlement or judgment in a legal action, the family shall reimburse the fund for the amount of assistance received, or that portion thereof covered by the amount of the damages less the expense of recovery;
(4) Establish the amount of reimbursement for the medical expenses of each child using a sliding fee scale based on a family's ability to pay for medical expenses which takes into account family size, family income and assets and family medical expenses and adjust the financial eligibility criteria established in the definition of catastrophic illness pursuant to § 23-1.12-1 based upon the monies available in the fund;
(5) Disseminate information on the fund and the program to the public;
(6) Adopt bylaws for the regulation of its affairs and the conduct of its business, adopt an official seal and alter the same at pleasure, maintain an office at the place within the state as it may designate, and sue and be sued in its own name;
(7) Appoint, retain or employ staff, experts or consultants on a contract basis or otherwise, who are deemed necessary, and employ investigators or other professionally qualified personnel as may be within the limits of funds appropriated or otherwise made available to it to accomplish its purposes;
(8) Maintain confidential records on each child who applies for assistance under the fund;
(9) Take all actions deemed necessary to implement the purposes of this chapter; and
(10) Adopt rules and regulations in accordance with chapter 35 of title 42 ("administrative procedures"), necessary to effectuate the purposes of this chapter.
23-1.12-7. Settlement of claims.
The commission is authorized to negotiate or settle a claim that the fund maintains for reimbursement against a family who has received assistance for the medical expenses of a child with a catastrophic illness pursuant to this chapter and has recovered damages in a legal action for the child's medical expenses. Money recovered pursuant to this section shall be deposited in the fund.
23-1.12-8. Eligibility.
(a) A child who is a resident of this state is eligible, through the child's parent, parents or legal guardian, to apply to the program established pursuant to § 23-1.12-6.
(b) In the event a family has more than one child with a catastrophic illness, as defined LC003655 - Page 4 of 7 pursuant to § 23-1.12-1, the commission shall waive the family responsibility, as established by rule or regulation, for the other child if the family has met the family responsibility for the first child in a state fiscal year.
23-1.12-9. Financial assistance.
Whenever a child has a catastrophic illness and is eligible for the program, the child, through the child's parent, parents or legal guardian, shall receive financial assistance from monies in the fund subject to the rules and regulations established by the commission and the availability of monies in the fund. The financial assistance shall include, but is not limited to, payments or reimbursements for the cost of medical treatment, hospital care, drugs, nursing care and physician services.
23-1.12-10. Annual surcharge per employee subject to the employer security act.
For the purpose of providing the monies necessary to establish and meet the purposes of the fund, the commission shall establish a one dollar and fifty cent ($1.50) annual surcharge per employee upon all employers who are subject to the employment security laws pursuant to chapters 42, 43 and 44 of title 28. The surcharge shall be collected by the director of the department of labor and training and paid over to the general treasurer for deposit in the fund annually as provided by the commission.
23-1.12-11. Rules and regulations.
The general treasurer shall adopt rules and regulations establishing procedures for the collection of the surcharge contained in § 23-1.12-10.
23-1.12-12. Annual reports.
(a) The commission shall report annually to the governor and to the committees of the senate and house of representatives with responsibility for issues affecting children, health and human services on the status of the program. The report shall include the following information:
(1) The number of participants in the program;
(2) Average expenditures per participant;
(3) The nature and type of catastrophic illnesses for which the fund provided financial assistance; and
(4) The average income and expenditures of families who received financial assistance under the program.
(b) The commission also may make recommendations for changes in the law and regulations governing the fund to the general assembly as a portion of its report. LC003655 - Page 5 of 7
SECTION 2. This act shall take effect upon passage.