Rhode Island is at its Breaking Point: Coalition urges General Assembly to act on federal cuts threatening healthcare, food access, and economic stability

“Rhode Island must act now to prevent widespread harm and ensure economic security for all residents.”

From a press release:

The Economic Progress Institute (EPI) and nearly two dozen additional policy and community organizations recently called on the General Assembly to take immediate action to protect residents from the harmful impacts of the federal One Big Beautiful Bill Act (H.R.1).

There are already crisis-level shortages in housing, affordable childcare, and elder care, the coalition warns in its letter,¹ delivered late last week. There is also a shortage of primary care doctors, and many are being forced to go without health insurance, not because they don’t need it, but because they can’t pay for it. In addition, Rhode Island has one of the highest rates of chronic homelessness in the country.

Meeting basic needs has even become an impossible challenge for so many neighbors, essential workers, families, small business owners, older residents, and more. With H.R.1, 53,000 residents risk losing health coverage, and up to 14,000 could lose SNAP benefits unless the state takes action.

“Rhode Island is already at its breaking point,” said Nina Harrison, EPI’s policy director. “These federal cuts will worsen the state’s affordability challenges, deepen inequities, and push more families into instability unless our elected officials act decisively now.”

The coalition outlines several urgent risks:

• Healthcare system strain: Increased uninsured residents could overwhelm emergency rooms and raise costs statewide

• Rising inequity: Disproportionate harm to immigrant communities and Rhode Islanders of color

• Food insecurity: Thousands at risk of losing SNAP benefits amid rising costs

These impacts could lead to increased homelessness, uncompensated hospital care, and long-term economic instability. To mitigate these risks, the coalition urges lawmakers to:

• Advance tax justice by taxing the top one percent of income earners (only on taxable income above $640,000 per year) to generate over $200 million annually;

• Protect healthcare access through state subsidies and expanded care systems;

• Strengthen food security by investing in SNAP and local service providers; and

• Invest in community infrastructure, including transit, workforce programs, and public communication systems.

“The path forward requires bold action and equitable investment,” states the coalition in its letter sent to all General Assembly members, Governor Daniel McKee, and members of his staff during an advocacy day at the State House on March 19. “Rhode Island must act now to prevent widespread harm and ensure economic security for all residents.”

1. Here’s the “Open Letter to Rhode Island General Assembly Members”

MMarch 19 2026

Dear Members of the Rhode Island General Assembly,

Rhode Island is at a breaking point. Across the state, Rhode Islanders are experiencing crisis-level shortages of affordable childcare, housing, and elder care, as well as a shortage of primary care doctors, and one of the highest rates of chronic homelessness in the country. At the same time, Rhode Islanders are struggling to manage sharp increases in the cost of goods and healthcare, as well as service cuts to the Rhode Island Public Transit Authority (RIPTA).

We appreciate the steps the Governor and the RI General Assembly have taken to address each of these issues. Unfortunately, for many, simply meeting basic needs has become an impossible challenge. The federal One Big Beautiful Bill Act (OBBBA, aka H.R.1), passed on July 4, 2025, will violently strip assistance from 53,000 Rhode Islanders who will lose health insurance and up to 14,000 who are at risk of losing SNAP – all to pay for tax cuts for the wealthiest.

A coalition of 24 Rhode Island policy experts and community organizations came together to assess what’s at stake and propose solutions. The findings are clear and alarming: without intervention, OBBBA will cause widespread harm to families, communities, and the systems that sustain them.

Call to Action:

We urge you to advance tax justice and raise all revenue necessary to protect Rhode Islanders from significantly increased food insecurity, homelessness, poverty, racial disparities, uncompensated hospital care, and systemic breakdowns across the healthcare industry.

Key Concerns and Risks

1. Healthcare System Collapse

   1. Emergency Room Overload: Loss of coverage will push uninsured residents into ERs, increasing wait times and costs.

   2. Hospital Solvency: Increased uncompensated care could lead to hospital closures.

   3. Rising Costs: As healthier people forgo insurance, premiums will rise for everyone.

   4. Access to Medication: Uninsured residents will face dangerous gaps in prescriptions, increasing reliance on unsafe alternatives.

   5. Healthcare Workforce: Attacks on immigrant communities could have a significant impact on our healthcare workforce; in 2021, 40% of home health aides in the US were born in foreign countries.

   6. The state will lose hundreds of millions of dollars a year in federal Medicaid funding.

2. Economic and Racial Inequity

   1. The harm of OBBBA will fall hardest on immigrant communities and Rhode Islanders of Color, compounding existing disparities in income, housing, and health.

   2. Some families could simultaneously lose SNAP, Medicaid, Head Start, and Child Tax Credits, all while navigating reduced RIPTA service and heightened fear of deportation.

   3. Safeguard the personal data and information of public benefits recipients from federal overreach.• Protect due process rights for immigrants and individuals receiving benefit change notices.

3. Food Insecurity

   1. Up to 14,000 Rhode Islanders may lose SNAP benefits, and there is an ongoing threat of SNAP benefits being electronically stolen (“skimming”) from beneficiaries, as was the case in March 2025.

   2. High SNAP error rates could make the state responsible for up to $65 million in new cost-sharing.

   3. Direct service organizations are facing funding shortfalls as demand rises, and may not have the capacity to meet community needs – increased food insecurity will worsen health and educational outcomes.

Solutions for a Just and Stable Rhode Island

1. Advance Tax Justice and Raise Revenue Equitably

   1. Pass a bill to tax the top 1% of income earners (approximately 6,100 tax filers) to generate $203 million annually. Since 2017, the top 1% have benefitted from federal tax cuts that have now been made permanent and are being paid for by cuts to vital public services.

   2. RI follows rolling conformity for taxes, meaning federal tax changes automatically become state law unless the state explicitly decouples from them. RI could save at least $35 million/year (beginning Tax Year 2026) by decoupling from certain Federal tax changes under the OBBBA.

   3. Create a state Child Tax Credit to reduce poverty and support families.

   4. Increase the state Earned Income Tax Credit (EITC) to put more money in Rhode Islanders’ pockets and make the state more competitive with our neighbors.

   5. Help family caregivers through a caregiver tax credit program.

2. Protect Healthcare Access

   1. Fully fund a new system to deliver healthcare for those losing coverage, particularly immigrants. This could include increased funding for uncompensated care, revising charity care laws, and/or creating a state-run pharmacy for life-saving medications.

   2. Establish a state subsidy to replace federal enhanced premium tax credits that expired for 46,000 residents who purchase coverage through HealthSourceRI at the end of 2025. Without those subsidies, premiums have doubled, on average.

   3. Prevent the spread of scam insurance plans and expand support for medically assisted addiction treatment programs to avoid life-threatening disruptions in care.

3. Ensure Food and Basic Needs Security

   1. Increase investment in SNAP, the Rhode Island Food Bank, and local direct-service organizations that provide essential aid.

   2. Prevent ongoing electronic theft (“skimming”) of SNAP benefits by upgrading EBT cards with tap/chip technology; fully reimburse the $750,000+ in SNAP benefits stolen from Rhode Islanders in 2025.• Provide a cost-of-living increase for RI Works recipients and restore the cost-of-living increase for those receiving the RI SSI supplement.

4. Strengthen State Capacity and Community Partnership

   1. Increase DHS staffing to manage changes, respond to public inquiries, and reduce administrative errors.

   2. Ensure public communication provides adequate notice that is timely, clear, and culturally appropriate by partnering with schools, churches, libraries, HEZ groups, small businesses, and trusted community organizations.

   3. Fund local community-based organizations to help residents navigate benefit systems.

   4. Expand workforce development, adult education, and volunteer programs to meet work requirement needs.

   5. Reverse service cuts and fully fund RIPTA, which thousands of SNAP and Medicaid recipients rely on for access to work, healthcare, and food.

5. Collaborate with neighboring states on OBBBA implementation to share data and strategies that minimize harm.

The path forward requires bold action and thoughtful investment, not cuts. We call on you to protect Rhode Islanders and stand ready to work with you to ensure Rhode Island does not descend into a state of emergency from which it could take decades to recover.

Sincerely,

• ACLU of RI

• Alliance of RI Southeast Asians (ARISE)

• Alliance to Mobilize Our Resistance (AMOR)

• Commission for Health Advocacy and Equity CHAE

• Direct Action for Rights and Equality (DARE)

• Economic Progress Institute

• Housing Network of Rhode Island

• Immigrant Coalition of Rhode Island

• Latino Policy Institute

• Progreso Latino

• RI AFL-CIO

• RI Center for Justice

• RI Coalition Against Domestic Violence

• RI Council of Churches

• RI Interfaith Coalition to Reduce Poverty

• RI KIDS COUNT

• RI Parent Information Network (RIPIN)

• SEIU State Council

• Senior Agenda Coalition of RISISTA Fire

• Women’s Fund of Rhode Island

• The Womxn Project