Rhode Islanders can have an exchange, insurance products, and premium subsidies for $38 million, or we can have essentially the same things for $-0-.


Stenhouse Counters Lt. Governor Roberts Statement  – click here for commentary

Analysis: THEY KNEW in 2009!

CEO Stenhouse’s Written Testimony on House Bill #7817

Report: $38 million or Zero?

Report: Moving RI’s Exchange to the Feds article

Other media:

June 18, 2014: Plan to expand HealthSourceRI and ‘socialize’ healthcare in RI: rationing, price fixing, etc …

May 4, 2014: Gary D. Alexander OpEd (RI’s former secretary of Health and Human Services)

May 20, 2014: Providence Journal Editorial Staff Agrees

May 22, 2014: Center’s Statement on HealthSourceRI press conference announcing federal requirement that the state must spend money in 2015 on its exchange

May 23, 2014: Ocean State Current analysis shows administrations claims of ‘federal fee’ are unfounded

June 3, 2014: Lt. Gov. Roberts Response on

June 4, 2014: Wall Street Journal article


In order to comply with President Obama’s Affordable Care Act (ACA), often referred to as Obamacare, each state had the option of establishing its own insurance exchange, that would be financed initially by federal funds, or, they could leave it to the federal government to set up the complex network of insurance carriers, products, and subsidies.

In Rhode Island, the exchange was established by Executive Order of the Governor in 2011, after the state’s legislative body voted against its creation earlier that year. Federal funds to pay for development of the exchange are soon due to expire. Whether or not the state should find a way to pay for the ongoing $38 million annual expense for the exchange (and a related side project) is the issue at hand.


  • there is no viable funding source in RI to pay for continued operation of the exchange;
  • there appears to be no legal barrier to a transfer;
  • there should be no loss of benefits to policyholders;
  • the state should not have to repay funds it has already spent;
  • the federal exchange operates at a much lower cost per enrollee

2014 Legislation

House Bill #7817 would authorize a transfer to the federal government and ensure that no local funds would be used to pay for the operations of the HealthSourceRI exchange

Senate Bill #2740 would do the same.

Related Reports

As the Center projected in its 2012 report, the cost to Rhode Island in operating the exchange would become a budgetary problem. Further, as the Center also projected in its summer 2013 report,  Left Behind by Healthcare in RI, HealthSourceRI will not meet its goal of providing coverage to most uninsured Ocean Staters.

In 2014, new analysis is provided by the Center’s Adjunct Scholars for healthcare – Gary Alexander and Sean Parnell:

Report: $38 million or Zero?

Report: Moving RI’s Exchange to the Feds

Other healthcare reform related items …


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