Bill Sponsors
Lawson, and Murray
Committee
Senate Health & Human Services
Summary
Select
This bill updates the rules for Medicare Supplement Insurance, also known as Medigap. It changes the starting point for calculating continuous coverage to qualify for guaranteed enrollment. Instead of requiring continuous coverage starting from a person's Initial Enrollment Period, it now requires continuous coverage starting from their Medigap Open Enrollment Period. As long as a person hasn't had a gap in health coverage of more than 90 days since that time, insurance companies must allow them to switch or enroll in any available Medigap policy during the annual enrollment period without checking their medical history or health status.
Sponsor
Analysis
Pros for Progressives
- Expands healthcare access by ensuring individuals with pre-existing conditions cannot be denied Medicare supplement coverage or subjected to medical underwriting if they maintain continuous coverage.
- Protects vulnerable populations, including the elderly and disabled, from predatory insurance practices by guaranteeing their right to switch plans during the annual enrollment period.
- Strengthens the social safety net by aligning continuous coverage requirements with the Medigap Open Enrollment Period, making it easier for individuals to navigate and secure affordable supplemental healthcare coverage.
Cons for Progressives
- Still requires individuals to have maintained continuous coverage (no gap greater than 90 days), which could penalize those who temporarily lost coverage due to financial hardship or systemic barriers.
- Does not mandate universal, free supplemental coverage, continuing to rely on private profit-driven insurance companies to fill the gaps left by the traditional Medicare system.
- Individuals under the age of 65 with disabilities are still restricted to guaranteed issue rights specifically for Plan A policies, rather than having access to the full range of supplemental plans available to older adults.
Pros for Conservatives
- Encourages personal responsibility by rewarding individuals who independently maintain continuous health insurance coverage with guaranteed issue rights to switch plans.
- Promotes a competitive free market by allowing consumers to shop around and switch to different private Medicare supplement plans annually, forcing insurers to compete for their business.
- Maintains the role of private insurance companies in the healthcare system rather than expanding government-funded Medicare to cover all healthcare costs.
Cons for Conservatives
- Imposes strict government mandates on private insurance companies, forcing them to accept applicants regardless of their health status or pre-existing conditions, which restricts corporate freedom.
- Prohibits insurers from performing individual medical underwriting for these applicants, stripping companies of their ability to accurately assess risk and price their policies accordingly.
- Increases regulatory burdens on the insurance industry by expanding guaranteed issue rights, which could potentially drive up premium costs for all policyholders to offset the risk of insuring sicker individuals.
Constitutional Concerns
None Likely. The bill regulates the insurance industry, specifically Medicare supplement policies, which falls well within the state's established regulatory authority over insurance markets. It does not infringe upon free speech, due process, or involve unreasonable searches and seizures.
Impact Overview
Groups Affected
- Medicare beneficiaries
- Seniors
- Individuals with disabilities
- Individuals with end-stage renal disease
- Health insurance companies
Towns Affected
All
Cost to Taxpayers
None
Revenue Generated
None
BillBuddy Impact Ratings
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Public Services
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Regulatory
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Clarity of Bill Language
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Environmental Impact
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Privacy Impact
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Bill Status
Current Status
Held
Comm Passed
Floor Passed
Law
History
• 05/12/2026 Introduced, referred to Senate Health and Human Services
• 05/15/2026 Scheduled for hearing and/or consideration (05/21/2026)
• 05/21/2026 Committee recommended measure be held for further study
• 05/15/2026 Scheduled for hearing and/or consideration (05/21/2026)
• 05/21/2026 Committee recommended measure be held for further study
Bill Text
SECTION 1. Section 27-18.2-3 of the General Laws in Chapter 27-18.2 entitled "Medicare Supplement Insurance Policies" is hereby amended to read as follows:
27-18.2-3. Standards for policy provisions.
(a) No Medicare supplement insurance policy or certificate in force in the state shall contain benefits that duplicate benefits provided by Medicare.
(b) Notwithstanding any other provision of law of this state, a Medicare supplement policy or certificate shall not exclude or limit benefits for loss incurred more than six (6) months from the effective date of coverage because it involved a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage.
(c) The commissioner shall adopt reasonable regulations to establish specific standards for policy provisions of Medicare supplement policies and certificates. Those standards shall be in addition to and in accordance with the applicable laws of this state, including but not limited to §§ 27-18-3(a) and 42-62-12 and regulations promulgated pursuant to those sections. No requirement of this title or chapter 62 of title 42 relating to minimum required policy benefits, other than the minimum standards contained in this chapter, shall apply to Medicare supplement policies and certificates. The standards may cover, but not be limited to:
(1) Terms of renewability;
(2) Initial and subsequent conditions of eligibility;
(3) Nonduplication of coverage;
(4) Probationary periods;
(5) Benefit limitations, exceptions, and reductions;
(6) Elimination periods;
(7) Requirements for replacement;
(8) Recurrent conditions; and
(9) Definitions of terms.
(d) The commissioner may adopt reasonable regulations that specify prohibited policy provisions not specifically authorized by statute, if, in the opinion of the commissioner, those provisions are unjust, unfair, or unfairly discriminatory to any person insured or proposed to be insured under a Medicare supplement policy or certificate.
(e) The commissioner shall adopt reasonable regulations to establish minimum standards for premium rates, benefits, claims payment, marketing practices, and compensation arrangements and reporting practices for Medicare supplement policies and certificates.
(f) The commissioner may adopt any reasonable regulations necessary to conform Medicare supplement policies and certificates to the requirements of federal law and regulations promulgated pursuant to federal law, including but not limited to:
(1) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements;
(2) Establishing a uniform methodology for calculating and reporting loss ratios;
(3) Assuring public access to policies, premiums, and loss ratio information of issuers of Medicare supplement insurance;
(4) Establishing a process for approving or disapproving policy forms and certificate forms and proposed premium increases;
(5) Establishing a policy for holding public hearings prior to approval of premium increases that may include the applicant’s provision of notice of the proposed premium increase to all subscribers subject to the proposed increase, at least ten (10) days prior to the hearing; and
(6) Establishing standards for Medicare select policies and certificates.
(g) Each Medicare supplement Plan A policy or applicable certificate that an issuer currently, or at any time hereafter, makes available in this state shall be made available to any applicant under the age of sixty-five (65) who is eligible for Medicare due to a disability or end- stage renal disease, provided that the applicant submits their application during the first six (6) months immediately following the applicant’s initial eligibility for Medicare Part B, or alternate LC006468 - Page 2 of 4 enrollment period as determined by the commissioner. The issuance or coverage of any Medicare supplement policy pursuant to this section shall not be conditioned on the medical or health status or receipt of health care by the applicant; and no insurer shall perform individual medical underwriting on any applicant in connection with the issuance of a policy pursuant to this subsection.
(1) Any individual under the age of sixty-five (65) enrolled in a Medicare supplement Plan A by reason of disability or end-stage renal disease pursuant to subsection (g) of this section, shall receive a six-month (6) open enrollment period for any policy or applicable certificate that an issuer currently makes available in this state beginning on the first day of the month in which the individual both attains the age of sixty-five (65) and remains enrolled in Medicare Parts A & B.
(h) Each year, for the duration of the Medicare Annual Enrollment Period (AEP) for coverage with an effective date of January 1 of the following year, an individual enrolled in a Medicare supplement policy or Medicare Advantage plan who has been covered by any Medicare supplement policy(s) or Medicare Advantage plan(s) or another form of credible coverage with no gap in coverage greater than ninety (90) days beginning from that individual’sMedicare Initial Enrollment Period (IEP) Medigap Open Enrollment Period, shall be afforded guaranteed issue rights for any available Medicare supplement policy or applicable certificate that an issuer currently makes available in this state.
(1) The issuance or coverage of any Medicare supplement policy pursuant to subsection (h) of this section shall not be conditioned on the medical or health status or receipt of health care by the applicant and no issuer shall perform individual medical underwriting on any applicant in connection with the issuance of a policy pursuant to this subsection.
(2) For those individuals under the age of sixty-five (65) enrolled in a Medicare Advantage or Medicare supplement Plan A due to a disability, pursuant to subsection (g) of this section the individual shall be afforded guaranteed issue rights for every Medicare supplement Plan A policy or applicable certificate that an issuer makes available in this state. Coverage shall be afforded pursuant to subsection (h)(1) of this section.
SECTION 2. This act shall take effect upon passage.
27-18.2-3. Standards for policy provisions.
(a) No Medicare supplement insurance policy or certificate in force in the state shall contain benefits that duplicate benefits provided by Medicare.
(b) Notwithstanding any other provision of law of this state, a Medicare supplement policy or certificate shall not exclude or limit benefits for loss incurred more than six (6) months from the effective date of coverage because it involved a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months before the effective date of coverage.
(c) The commissioner shall adopt reasonable regulations to establish specific standards for policy provisions of Medicare supplement policies and certificates. Those standards shall be in addition to and in accordance with the applicable laws of this state, including but not limited to §§ 27-18-3(a) and 42-62-12 and regulations promulgated pursuant to those sections. No requirement of this title or chapter 62 of title 42 relating to minimum required policy benefits, other than the minimum standards contained in this chapter, shall apply to Medicare supplement policies and certificates. The standards may cover, but not be limited to:
(1) Terms of renewability;
(2) Initial and subsequent conditions of eligibility;
(3) Nonduplication of coverage;
(4) Probationary periods;
(5) Benefit limitations, exceptions, and reductions;
(6) Elimination periods;
(7) Requirements for replacement;
(8) Recurrent conditions; and
(9) Definitions of terms.
(d) The commissioner may adopt reasonable regulations that specify prohibited policy provisions not specifically authorized by statute, if, in the opinion of the commissioner, those provisions are unjust, unfair, or unfairly discriminatory to any person insured or proposed to be insured under a Medicare supplement policy or certificate.
(e) The commissioner shall adopt reasonable regulations to establish minimum standards for premium rates, benefits, claims payment, marketing practices, and compensation arrangements and reporting practices for Medicare supplement policies and certificates.
(f) The commissioner may adopt any reasonable regulations necessary to conform Medicare supplement policies and certificates to the requirements of federal law and regulations promulgated pursuant to federal law, including but not limited to:
(1) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements;
(2) Establishing a uniform methodology for calculating and reporting loss ratios;
(3) Assuring public access to policies, premiums, and loss ratio information of issuers of Medicare supplement insurance;
(4) Establishing a process for approving or disapproving policy forms and certificate forms and proposed premium increases;
(5) Establishing a policy for holding public hearings prior to approval of premium increases that may include the applicant’s provision of notice of the proposed premium increase to all subscribers subject to the proposed increase, at least ten (10) days prior to the hearing; and
(6) Establishing standards for Medicare select policies and certificates.
(g) Each Medicare supplement Plan A policy or applicable certificate that an issuer currently, or at any time hereafter, makes available in this state shall be made available to any applicant under the age of sixty-five (65) who is eligible for Medicare due to a disability or end- stage renal disease, provided that the applicant submits their application during the first six (6) months immediately following the applicant’s initial eligibility for Medicare Part B, or alternate LC006468 - Page 2 of 4 enrollment period as determined by the commissioner. The issuance or coverage of any Medicare supplement policy pursuant to this section shall not be conditioned on the medical or health status or receipt of health care by the applicant; and no insurer shall perform individual medical underwriting on any applicant in connection with the issuance of a policy pursuant to this subsection.
(1) Any individual under the age of sixty-five (65) enrolled in a Medicare supplement Plan A by reason of disability or end-stage renal disease pursuant to subsection (g) of this section, shall receive a six-month (6) open enrollment period for any policy or applicable certificate that an issuer currently makes available in this state beginning on the first day of the month in which the individual both attains the age of sixty-five (65) and remains enrolled in Medicare Parts A & B.
(h) Each year, for the duration of the Medicare Annual Enrollment Period (AEP) for coverage with an effective date of January 1 of the following year, an individual enrolled in a Medicare supplement policy or Medicare Advantage plan who has been covered by any Medicare supplement policy(s) or Medicare Advantage plan(s) or another form of credible coverage with no gap in coverage greater than ninety (90) days beginning from that individual’s
(1) The issuance or coverage of any Medicare supplement policy pursuant to subsection (h) of this section shall not be conditioned on the medical or health status or receipt of health care by the applicant and no issuer shall perform individual medical underwriting on any applicant in connection with the issuance of a policy pursuant to this subsection.
(2) For those individuals under the age of sixty-five (65) enrolled in a Medicare Advantage or Medicare supplement Plan A due to a disability, pursuant to subsection (g) of this section the individual shall be afforded guaranteed issue rights for every Medicare supplement Plan A policy or applicable certificate that an issuer makes available in this state. Coverage shall be afforded pursuant to subsection (h)(1) of this section.
SECTION 2. This act shall take effect upon passage.