Rhode Island Speaker Joe Shekarchi visits Richmond

"I will tell you that we’re struggling in this State. Things are not good. We have many more expenses, driven by a lot more need and less revenue."

Representative Megan Cotter (Democrat, District 39, Exeter, Richmond, Hopkinton) introduced Rode Island’s Speaker of the House, K. Joseph Shekarchi, to her constituents at the Clark Memorial Library in Richmond, RI. Speaker Shekarchi spoke at length about the budget process, housing, healthcare, the Trump Administration, and climate change.

Here’s the transcript, edited for clarity:

Representative Megan Cotter: When I asked the Speaker to come and do this event, I wanted to focus on healthcare. I don’t know how many folks have looked at the Governor’s budget, but to me, it’s incredibly lackluster, especially in healthcare, and right now, one-third of our budget is Medicaid. If we see cuts, that would be highly detrimental to our community, so we need to fix the budget.

The guy who knows the most about the budget and who will fix it is sitting right here.

Rhode Island Speaker K. Joseph Shekarchi: Thank you for coming on a Saturday during a cold winter. I can’t tell you how lucky you are to be represented by Megan Cotter, a rockstar of the House. She works very hard for her community. I don’t want to start talking about it because I have 75 reps, and they get a little jealous when I praise one of them. But Megan has done so much for her community in her first term. It is unbelievable. She helped get RIPTA service to Wood River Junction. She helped establish a commission, working across the aisle with Republican Leader Michael Chippendale, on fire safety and conservation.

I know there was an issue with taxes with Richmond. I don’t know - the Town Council had something - and Megan came to me and said, this is important to my community, and we have to stop it or push it - I don’t remember what it was, but we did it for Megan. Whatever it was Megan asked, we dis.

I’m happy to talk about healthcare a little bit or about any issue. I enjoy the opportunity to speak directly to Rhode Islanders. It makes me feel I get more in touch with what’s happening and your feelings. If you want to talk, although I’m very limited in what I can do about national issues, I’ll be happy to. I will tell you that I was in Washington last weekend, last Friday, Saturday, and Sunday, and I was with Speakers from around the country - Democrat and Republican Speakers - and you’d be surprised how unanimous we were in dealing with the federal government.

It’s not a blue-state issue or a red-state issue. It is every person’s state issue because we have the same problems, whether it’s the far-left progressives or the far-right freedom caucus in different states. Everyone has - I’ll use the word - an extreme wing of their party, and they attack leadership without solutions and without ideas to fix it. Unfortunately, when you get elected like Megan and I have, and Megan hasP ... people say, “Look what you get.” Well, $19,000 is what we get. $19,000 for a year-round position, even though we’re only in session from January to June. If you choose to do it well, Megan does it well. The job of a representative is to work all year round.

Megan is working on a Saturday morning on vacation week. This is a vacation week at the State House. We have to take a break for February school vacation and another for April school vacation because many people have families and want to go away with their children to Disney, etc. So we try to preserve that. My majority leader and I are very close. We’re best friends in many ways. I do not talk to him on the weekend. He’s got two small children, and I respect him, and I like him. But more importantly, his job is to be their father and husband more than it is to be a politician. He’s going to be a great Speaker one day.

I will tell you that we’re struggling in this State. Things are not good. We have many more expenses, driven by a lot more need and less revenue. We can discuss solutions to both problems because everybody has solutions. Solutions, to me, are when you bring people together and come to a solution that most people—not all people, but most people—can buy into. Unfortunately, that’s not always the case.

The Governor gives everyone a view of the process and composes his budget. He starts in the summer and bases it on his policy ideas. He sets that in November when we do our revenue conference. We do two revenue conferences yearly, one in November and one in May.

The November revenue conference is a projection of where we think we’ll be in July. We look at the caseloads in our hospitals, the children in DCYF’s care, and our prison intake—people we have to take care of as a State. It’s our obligation.

We look at the revenue forecast, quarterly returns, and the economy. The revenue conference includes the House Fiscal Staff—which I will tell you is the best in the State and the country—the Senate Fiscal Staff—they do an excellent job—and the Governor’s budget office. The three offices meet to discuss all this data, and they will only predict if all three agree.

If they don’t agree, they wait until they agree because we want to ensure we are all working off the same numbers. Each branch of the government, the House, the Senate, and the Executive Office, has a tremendous amount of input about what goes into the budget. It emanates from the House - we have the most responsibility. It’s the single most significant responsibility we have. You can talk about any bill or issue you want, but our budget is the most important thing we do. It’s by the Constitution. We have a constitutional obligation to pass a balanced budget, and we will.

Since I’ve been Speaker, I’m proud we’ve done five budgets in four years. It’s a little bit of an anomaly because of Covid. Every one of those budgets has been balanced and bipartisan, and that’s not easy to do, but I strive to do it. Maybe this year, we won’t be bipartisan. Republicans and the State seem a little more emboldened - excited - whatever you want to call it, because of the change in Washington. So I don’t know if they will be as bipartisan, but we’ll try because that’s all we can do. We’ll do our best.

After his November revenue numbers, the governor puts his budget together and gives it to the General Assembly in January. We have received it and started a process where every single article of that budget goes through public vetting. Our fiscal staff tears it apart, page by page, line by line, submits reports to all of us in the General Assembly - the budget, first glance; the budget, first review’ the budget in the details - and then we begin a process, that’s very open and transparent, and we accept. We encourage input from the public and stakeholders on the budget.

That includes healthcare, Medicare, Medicaid, what we decide to pay, and what we do to help people - whether it’s the Senior Coalition agenda, DCYF, the child advocate, or the business community. Every advocate you can imagine, from nursing homes to hospitals, everybody comes in with asks. That’s not new. This year, it’s more severe because they are terrified. We don’t have any more federal money. The COVID money, the CARES Act money, the infrastructure money - all of that is gone. We don’t have that ARPA money. We have spent and allocated it, and that’s a good thing. We’ve done that because when we take that federal money, we do not return a dime to the federal government. We spend it here in Rhode Island. As a matter of fact, through the efforts of Jack Reed, Sheldon Whitehouse, and our congressional delegation, we got a little bit of extra money in rent relief, and we were able to be very aggressive.

This is why you develop a good working relationship with the Senate and the Governor. When the federal government gives us money, they give us the money and follow up a month or two later with guidance on how to spend it. You must be careful not to overspend or spend it in the wrong area. In the middle of the pandemic, Rhode Islanders were hurting big time. So we got together, and the Governor, to his credit, said, “Speaker, I’m going to use a lot of this rent relief money to pay internet bills because people working from home need to pay utility bills, not just rent because we had a significant amount of money thanks to Jack Reed installing what we call a small state minimum. What that did is whenever they give out federal money, Rhode Island gets a small state minimum. It’s essential because the more prominent states would get more money. And fun fact: under Obama and Trump I - Obama, a prominent Democrat; Trump, a big Republican -we got more money under Trump I than we got under Obama. Why is that? Because Jack Reed installed a small state minimum to his credit. He sits on the appropriations committee. Sheldon Whitehouse was chairman of the budget committee, which benefited Rhode Island.

Unfortunately, we don’t have that anymore. What does that mean? As a State, we have to live within our means, and we will do that because we have no alternative. I know some people are proposing a significant tax increase on the wealthy, the rich, or small businesses, depending on how you view it. Some have proposed tax increases for everybody. Some have proposed dramatic cuts in social services. We go through a process. We listen to everybody. We come together as a Democratic Caucus and the House in general, and we pass what we think is good, and that judges us. Good or bad, you will vote for us or not vote for us based on what we do in the budget - more so than any other single-issue bill that we do. I’m proud of that. I’m proud of the work we’ve done. We’re going to continue to do that.

The public process has begun. I encourage everyone to participate by showing up and talking, calling Megan Cotter or your State Senator, or sending. An organization emails through an advocate for or against a proposal. That helps you because we take all of that; it matters. People say it doesn’t matter, but I can tell you, since I’ve been Speaker, it matters. We listen, we go through a vetting.

Eighteen senior staff sit around a table and review every scrap of evidence - testimony and exhibit letters -that’s brought before us on any given issue before we feel comfortable that the problem has had a public vetting. Then we move it through the House process, where it gets another public hearing, and then it gets voted on by the committee. Then it goes to the floor, and we ship it off to the Senate, and they go through the same process over there. It ends in the governor’s hands. Sometimes, the Governor signs things; sometimes, he lets them become law without signing them; sometimes, he vetoes them. That’s our process, so I encourage you all to be involved.

I will tell you about the federal cuts. There’s one certainty, and I’m not being political about Trump. I’m a Democrat, and you should all know that. It’s not a secret. But there’s one certainty about Trump, and I can tell you this from talking to a very strong Republican Speaker from Florida, a charming young man, 37 years old, who is very close to Donald Trump and his family. He said this to me this past Sunday: “One thing is certain. President Trump will change his mind frequently and without notice." His staff, the Senate, and the House don’t know it. The one constant thing about Trump is this total inconsistency. Whatever the position is today does not mean it’ll be the position tomorrow, whether it’s Ukraine, Mexico, Greenland, Iceland, the Panama Canal, or whatever. It could all change. We have to be prepared for that.

In my opinion, it’s not the best way to run a government. It’s not the best way to predict how to put a budget together and how to plan your life. But unfortunately, and this is what I tell people, especially my good friends on the left who get very nervous about Trump, I said, “Elections have consequences. And Donald Trump was elected president, whether you like them or not.” I didn’t vote for him. At the convention, I nominated Kamala Harris. I understand that everybody has strong views, and appreciate and respect that. But I will work with Trump, and I will work with anybody who benefits Rhode Island.

By the same token, if there’s something that anyone - Democrat or Republican - is doing to hurt the State, I’ll be the first one in line to fight them. I’ll stand up and do that, but I don’t carry any ideological shield that means because you are Republican or because you’re Donald Trump, I’m going to be against you because that’s not me. That’s not who I am. I govern by consensus. I try to respect everybody’s point of view, whether I agree with it or not, and I listen to it because I’m always in the learning mode. I want to hear. Please educate me. Please convince me. I challenge all of my representatives to come to me with ideas. Some are good, but I do not understand the consequences. I challenge them to convince me because they have to ultimately convince 38 other members of the House that this is a good idea before it passes.

I’m open to suggestions and ideas. If you have a better way to do something, please share it with me. I have changed my mind on issues and positions because compelling data has convinced me.

I’ll briefly touch upon housing and then open up with questions. Housing is important to me. We have a problem in this country. We have a problem in Rhode Island. We do not have enough housing. We can go back 30 years, to the 1990s, for the last piece of significant land use legislation we passed - before I became Speaker. We’ve become more and more restrictive. Some of it is environmental, some of it is NIMBYism. Some of it is that we have a beautiful home and don’t want anybody from the city or “those kinds of people” here.

I tell people that everybody wants affordable housing, but nobody wants it near them. They don’t understand what affordable housing means. Affordable housing is your police officers, firefighters, teachers, and nurses - the people who serve and live in the community. We’re trying to make housing more affordable for them.

We’ve passed over 45 pieces of legislation to make it easier, and Mean’s been there with me on them. This is what I tell people. We don’t make decisions at the State House that say yes or no to any project. We let the local cities and towns do that. We don’t pick where to put a house or a development. We let the local cities and towns do that. Not one piece of legislation we passed changes that take the decision-making control away or even the appointing authority away. We let the local community pick their own planning boards, zoning boards, and town councils, and they decide how many units and where they go.

What we’re trying to stimulate is more housing production. We’ll let you decide whether you need housing in an abandoned school or elsewhere. We haven’t waived or modified any DEM regulations to make it easier to build housing in sensitive environmental areas. We let that process stay because there’s a preservation issue. I’m working with a State rep in another community, a rural community, where there’s an issue about land being open space or affordable housing, and it’s a large piece of land. And I said, “Here’s my suggestion. Work for your local community does not have to be either/or. Let’s cut it in half. Let’s keep half of it for open space and the other half for affordable housing. See if that works for your community, and I sent them on their way.”

We are not forcing housing. People will say, “You’re making us! Qe can’t afford it! We don’t have the water here!” Well, guess what? If you don’t have water, you don’t build. We’re not saying you have to build houses with or without water. “We don’t have the sewer capacity here!” Guess what? If you don’t have sewers or you don’t have a septic system, you can’t build. We’re not changing any of that.

In the East Bay, I got some pushback. I think it was either Portsmouth or Tiverton, “You’re ramming down this housing; you’re going to destroy the water!” No, if you don’t have water capacity, you don’t build houses, and no one’s forcing you or penalizing you if you don’t. But if you have surplus property, if you can do it, and if you want to do it - we haven’t cut, at least not yet - anyone’s school, education aid, or city and town grant aid because you don’t have affordable housing. We’ve had a law for over 30 years that says each community is supposed to do its part to come up with about 10%. Some communities do it, meet it, exceed it, or are exempt because they have many more apartments - and some don’t even want to try. Those are the communities we’re trying to bring along.

I’ve collaborated with the League of Cities and Towns, and we try to work with each community. The issue doesn’t always have to be housing; it could be many other issues. However, I think you will find that two issues are relevant today in every poll. Depending on how you poll, the number one issue is housing or healthcare.

I don’t know what happened this weekend, but I know a Governor’s Association meeting with the President yesterday and today. In the spring, the previous President had a meeting with the national governors. In all 50 states, the number one issue for them was housing. That’s all 50 governors because there’s a lack of affordable housing.

I think it’s a very simple problem to diagnose - much harder to fix but simple to diagnose. We don’t have enough supply. If you have supply, you will stabilize the market. You’ll bring it down to affordable levels.

There was an issue in Johnston recently where they said affordable housing is a Chad Brown facility. That is so antiquated. That’s a 40 or 50-year-old term. You have to understand a little bit about what it is and the definition because if you understand, I’ve had great success in my community of Warwick explaining what it is.

The first time I was campaigning, talking about housing, it wasn’t a concern. But as I went back, it became a big concern. I knocked on the door of a beautiful home with a nice elderly couple. They clearly were retired and said to me, “What are you going to do about affordable housing?” I explained the bills I was working on and what I would do, and I asked them, “Why are you concerned? It seems like you’re retired. You’ve got a lovely home here.” And they said, “We’re not worried about us, Rep. We’re worried about our children and our grandchildren because they’re graduating and coming out of college and can’t afford a home. They’re moving to another state with cheaper housing where they can find a high-paying job and pay less because they’re coming out of college with student debt.”

What I can tell you about housing is that even if you have a beautiful home, it’s not an issue for you; it will probably be an issue for your children or grandchildren. We’re all in this together, and I’ll try to work creatively to find solutions.

Chris Kona: You talked a lot about the housing piece and mentioned healthcare as the other. What kinds of things is the House looking at in terms of helping with Medicaid and other healthcare issues?

Speaker Shekarchi: First of all, Medicaid is the state portion, for the most part, and Medicare is the federal portion, which, for the most part, is driven by federal dollars. We’re working with our congressional delegation and waiting to see what happens. I was heartened by my meeting with Republican Speakers this past week. They have the same concern I have about federal aid, especially in healthcare. I was happy to hear that they were so concerned because I’m hopeful that there are some strong Republican representatives - we only need three or four in the House, by the way, we don’t need a lot, whose districts would be impacted dramatically. They said, “We are calling our congressmen.” These are Republican Speakers calling Republican congressmen to say, “Don’t cut Medicare. Don’t hurt these people who need it the most.”

So we can solve all the problems; it comes down to money, and unfortunately, it’s money we don’t have. This budget has a lot of holes that need to be clarified. For instance, there’s a budget article that taxes Google and Facebook ads and has a $20 million revenue stream attached to it. In reality, after some preliminary research, one state in the country taxes them. When Maryland enacted it, Google and Facebook filed this action in State and federal court. Guess how much this brand new revenue they’ve raised? $0 because Google and Facebook said, “We’ll see you in court. We’re not going to pay.”

So, if the Governor’s budget passes the way he proposed, that $20 million is pretty flimsy. That’s not something I feel comfortable about - to put in an article that projects $20 million that we will likely not get. In these cases, there could be a ruling next week, next month, or three months that says the tax is unconstitutional as a violation of freedom of speech. And if that happens, where will we get that $20 million?

The point I’m making is that it’s just one portion of the budget we will examine over the next eight weeks. If we had money, we could backfill many of these programs, but our healthcare is in dire need. If you read Nesi’s Notes, Channel 12 did some in-depth reporting on healthcare. Our hospitals are looking for $90 million from the Governor, which was not in the budget. So they’ve come to the General Assembly and said, “Give us $90 million, and we will be able to tap into another additional $180 million of federal money.” That’s a great idea. The only problem is that I don’t have $90 million.

If you have any of you haven’t been to the State House, it is a beautiful building, and I encourage you all to come, but I assure you there is no printing press in the basement, and we don’t make money, unlike the federal government. Also, unlike the federal government, we have a constitutional obligation. We must pass a balanced budget, so we must live within our means. If you ask me, “What kind of programs do you like to fund?” I answer that I like to fund programs that work, have a track record of success, and get a federal match. In the case of the hospitals, it’s a two-to-one match. So I’d love to give the hospitals $90 million. That’s Brown University and Care New England based in Kent County, right in my home District in the City of Warwick - and they’re struggling.

I don’t even want to talk about Prospect, which is in bankruptcy, which we’re trying to get out of bankruptcy. That’s Fatima and St. Joseph’s Hospital. They are for-profit hospitals, paying $1.5 million in taxes to North Providence and Providence. Even if we can preserve them and keep them alive - all those jobs and all that critical healthcare - those two communities can’t afford - especially Providence - a $1.5 million tax cut.

So those things are on my mind, and there’s not much we can do. We’re looking at ways to be creative. We can try to help doctors by offering to pay some student debt if they stay in Rhode Island. We just authorized $150,000 to study whether starting a medical school in Rhode Island at URI makes sense. That’s not an immediate solution. It does not help us in the short term, but we need to look at the long term because we can’t look at the problems today and try to fix them. We need to look at what will happen next year and beyond. I’m not going to be Speaker forever.

We funded an initiative for bioscience. There’s a lot of buzz around it. It’s in Providence. We’re competing with Worcester and Boston, but we recruited a good company called Organogenesis from Massachusetts, with about 500 high-paying private-sector jobs and all kinds of medical therapies. I will continue to nurture that field, and there’s a lot of excitement surrounding it. We won’t see any success in that for three to four years.

We need to not just deal with the issue in front of us today. We’re also looking at ways to make it easier for foreign doctors to come here, relax some of the laws, some reciprocities. We passed a lot of compacts that say if you’re licensed in one state, you can automatically get your license in Rhode Island. I met with a group of doctors, particularly dermatologists from Eastern Europe and other parts of the United States, who wanted to come here and practice in Rhode Island. They had all kinds of regulatory approvals through the Department of Health and held licenses in Massachusetts, Mississippi, and other states. And we only offer the testing in Rhode Island once or twice a year. It doesn’t make any sense, so we’re working on legislation to make bringing more doctors here easier.

Healthcare boils down, to be quite honest with you, to doctors. We don’t have enough doctors in Rhode Island. My primary care doctor, younger than me, retired in October because she was burnt out. And guess what? I don’t have a primary care doctor, and I’ve been trying to get one, so I know what it’s like, and I feel for people trying to hang on. Healthcare is changing. I’m a diabetic, and I go to my endocrinologist, and they’re like, “This doctor’s not here anymore. It’s a new doctor now.” You don’t have what you used to have: a relationship and the trust that your doctor knew you. You’re a number. You’re a person on a chart, and it’s scary.

Sadly, other states around the country feel the same about Rhode Island. Some think the best way to solve this is to cut all the same pain. This is not unique to federal programs, and it lets the chips fall where they may. Unfortunately, people on a lower economic scale get hurt the most.

We’re going to do our best, but we are Rhode Island. I try to explain to my colleagues and everyone else that we’re the smallest of the 50 states, and elections have consequences. Donald Trump won, and he is our President; we must learn to accept that and work our best to get what we can—the best opportunities for Rhode Island. Sometimes, that may mean working and fighting with him, and I’m prepared to do both.

Questions and Answers

Tia Beckman: I agree that we need to think about the loss of jobs many people face. We must think about Medicaid and the revenue coming in, so why did we stop vehicle taxes? You could have small taxes for some people and bigger taxes for people who buy better cars. Then, there are the tolls for the highways. Whenever I go to New Hampshire, there’s a toll I need to pay. If it has to be all vehicles, can cars be 5 cents per toll booth so everybody chips in and we keep getting revenue? The third thing I think of is women’s reproductive health. Are we going to be able to keep that if it becomes a national problem, or is that something we don’t have to worry about?

Speaker Shekarchi: The first issue you talked about was taxing cars. That was seen by the majority thinking that I have this vision of where things will go, of reps - people, and then all 74 reps blindly follow me into the abyss, wherever that goes, whatever the Joe Shekachi position is. It doesn’t work that way. It’s a very collaborative process. I will tell you that most Representatives wanted to eliminate the car tax. It wasn’t fairly taxed. It was different tax rates and different valuations. You can be an Exeter and get a low tax bill for the same car, Providence or Narragansett, and get a very high tax bill. People felt like they were paying a sales tax when they bought the car and paid the gasoline tax, and it’s not fair to do that.

It was a collective decision by the majority of the body. We had done this as a State long before I got elected, and then, when things got bad, they put it back on. Then we decided about four years ago to take it back off. We gradually phased out it because we had some federal money. So we did it in four years instead of five years. Getting 38 representatives to institute a car tax again would be very difficult. I’m open to it if there’s enough support in the room. If there are 20 or 30 representatives who come forward and say, “This is the plan we want, and this is what we want to do, these are the revenue numbers we’re going to raise, and this is what we’re going to spend it on,” then I’m willing to keep an open mind, and I’ll listen to that.

As far as truck tolls go or in general - many years ago, before I was Speaker, we passed a law to toll trucks only; we put gantries up. It was working very well. We raised about $90 million. It was specifically designed so that any money raised when tolling on the interstate has to be used for the road only, which is good because we all know we have a bridge problem. It’s no secret, and we have to pay for that bridge. The money we received under the Biden Administration is now in question under the Trump Administration.

We have allocated over $600 million to Rhode Island for the Washington Bridge and all our bridges, but that is now in question. The construction has stopped and started again, stopped again, and started again. As I said earlier, the one consistency is that you don’t know what will happen next month, next week, or the next hour.

The National Truckers Association challenged the truck tolls. They filed a lawsuit in federal court, and they won. Rhode Island had to stop tolling trucks because we were giving a discount to Rhode Island truckers and charging out-of-state truckers more. The trucks were the same size and used the same amount of road. It was an unequal application of the law. Rhode Island appealed it, and we prevailed in the First Circuit Court of Appeals in Boston and Rhode Island. Now, we can reinstate truck holds, which will be revenue, but that will not be revenue for healthcare. All money is fungible, but that will be money used by the Department of Transportation.

I only care about the Rhode Island truckers, so we brought them in, and we’re working with them. I said, “We have no desire to toll trucks. It’s revenue. We need to fix the roads. So if you come up with any other revenue streams or ideas, whether raising taxes on trucks, registration fees, or licensing fees, that gives us the revenue we need, we don’t have to toll”. I don’t know if they can do that, but I wanted to give them a chance. In addition, it takes us about six months to reinstate the gantries and upgrade the software because now, with these cyber attacks, we’re trying to upgrade all our software. We’re putting in the latest and greatest with many antivirus programs.

Reproductive healthcare. We have done a lot in Rhode Island pre-Trump. We have instituted the Rhode Island Reproductive Healthcare Act. It allows people in Rhode Island the right to abortion if they so desire. That was very contentious. It was done pre-Trump Supreme Court because we thought it would be changing. What we did, and some people on the right didn’t like it, and some people on the left didn’t like it, but we codified Roe v. Wade. We took the 1974 federal decision that we had been operating under for 40 years in Rhode Island and mirrored it in Rhode Island. We codified it into Rhode Island law.

If we had a federal ban, that would be different, but we don’t have one. If it comes to a federal ban, there’s nothing we can do. It’s a federal law. If it passes Congress and the President signs it, Rhode Island and every other state is out of luck. There’s no exemption for Rhode Island, and there’s nothing we can do about it if there’s a federal ban. But there hasn’t been a federal ban with the overturning of Roe v. Wade. The Court said, “We’ll let each state decide.”

We did something else last year so that Rhode Islanders would have the choice to make their own healthcare decisions. Quite frankly, whether you’re pro-life or pro-choice, those decisions should be made between you, your doctor, and your religious person if you have one or believe in one. That’s not for the State to be involved, in my opinion. We shouldn’t be banning it, and we shouldn’t be telling people what to do. Those are very private personal decisions, and they’re healthcare. Not every abortion is for somebody who didn’t plan for an unwanted pregnancy. A lot of them are healthcare decisions. There’s the mother’s life; there’s the children’s life. These are very personal and individualized decisions; the State shouldn’t be involved in them. It shouldn’t be a public policy decision. It’s not my choice to make. It’s somebody else’s choice; some people can choose not to have one. I respect that position. I grew up as a Catholic. I went to Mount St. Charles, and I understand that, but some people don’t have that view and don’t want the right to make those decisions.

Last year, the number one ask from the Medical Society was for Rhode Island to pass a Shield bill. This bill would prevent other states from reaching into Rhode Island and punishing doctors who prescribe healthcare or abortion medicine or perform abortions in Rhode Island to out-of-state persons. If you were from the State of Mississippi and you came to Rhode Island to receive healthcare, abortion, medicine, or prescriptions and went back to Mississippi and they found out about it, they could go after the doctor in Rhode Island. We passed a bill last year that prevents that.

We’ve done our part as a State. There’s not much else we can do in Rhode Island. We also passed the Insurance Coverage Act so that people who receive healthcare from the State can also make these decisions. They’re covered for that. They were already covered before; if a doctor asked for it said it was medically necessary. But now we’ve taken that medical necessity requirement away, and we’re letting the person and their doctor make that decision. We don’t have to have a doctor write to the State and say that one is needed. We simplified that process, but there is nothing else Rhode Island can do. If there’s a federal ban on this or a federal ban on anything, there’s nothing we can do as a State. Like I said before, elections have consequences. If all other 49 states have to follow it, I wonder why people think Rhode Island doesn’t, because we have to. We’re part of the United States.

Desiree DesVergnes: Thank you for coming down to our little town. It’s a great town. I love it very much. I’m a family nurse practitioner. I live in Richmond and own a business in your District. When you speak about primary care and physicians, I ask that you include more of us. Nurse practitioners make up a huge workforce for primary care in Rhode Island, as do Physician Assistants. I am president of the Nurse Practitioners for Rhode Island and spoke on the SHIELD Bill last year. We were sponsors on that SHIELD bill as well. I was at the Health and Human Services (HHS) Committee, recognizing the importance of that bill. As nurse practitioners, we make up a huge portion of primary care, so please include us in your language. I love that you’re advocating for it, and many bills are coming this year. I’ll see Megan on Tuesday at HHS because primary care is so important. We have so many nurse practitioner programs here in the State, and those who trained here in our little State tend to stay here, which is different from our physician colleagues who train here at Brown or train nearby and don’t stay here. They’re pulled to other states for reimbursement rates because we in Rhode Island are reimbursed much lower than other states, and the burden is heavier here.

Speaker Shekarchi: First, thank you for coming to the State House to discuss the SHIELD Bill. You must be happy because it was not easy to pass.

Desiree DesVergnes: We were on that bill for a long time.

Speaker Shekarchi: It was a difficult bill. My policy director, Lynn Urbani, is here. She worked immensely hard on that because there was some language in there that we had to work on with the courts and Attorney General, and what I said to you in 30 seconds sounds good, but the bill is big - 60-some odd pages - and there were so many intricacies in there. We have a crackerjack team that went through every line and word and negotiated to ensure we passed it.

I apologize for not including nurse practitioners. Everyone talks about physicians, and I read an article this morning in Nesi’s Notes about doctors. That’s why it’s in my mind. But I have a tremendous amount of respect and gratitude for anybody in the healthcare profession. My father, who, by the way, turns 99 tomorrow, was a surgeon here in Rhode Island. He came here and ended up marrying my mother and raising a family here, but he was from a foreign country. He wasn’t from the United States, but he loved Rhode Island, and he performed healthcare, a lot of it, in the Pawtucket/Central Falls/Woonsocket area. He did a lot of pro bono work. I still see people, even a colleague of ours, who said, “Your father operated on me when I was young, and I grew up poor. He didn’t charge us.” What you do, Desiree, what everybody in healthcare does, is a calling, and you are here because you care about people.

You care about Rhode Island because you’re right; our reimbursement rates are low. That’s a whole ‘nother issue. The Rhode Island Foundation studied why our rates are so low in Rhode Island. It’s because we in the General Assembly and I would be the first ones to plead guilty, and we pass legislation. I passed a bill mandating coverage for all mastectomy supplies. If you were a woman and you had a mastectomy, a lot of those supplies were not covered. It’s now mandated that they’re covered. It sounds good, but it’s expensive. It makes the premiums go higher for people. Health insurance premiums are not low by any stretch of the imagination, and it also keeps the reimbursements low. In the last two years, we’ve tried to look carefully at any new bills that increase mandates.

There’s a bill coming in - it sounds good - to cover EpiPens a hundred percent and no copay. When I say cover them, a lot of this is covered, but there’s an 80/20 sometimes or 70/30 or 90/10 copay. It doesn’t come from the insurance company when you mandate that insurance companies pay it. It gets passed on to the ratepayers. For every dollar that comes in, so much goes out and is kept to run the place. But unless you’re going to increase the premiums - there was a bill last year to dramatically increase premiums by 60% to fund all of the stuff we’re talking about - or you cut the coverages. That’s why there’s a low reimbursement rate. It’s a problem, and we need to fix it.

I’ve met with the doctors. I’ve met with the hospitals. When we get our second revenue conference numbers in May, that’s what we set our budget on, and that’s more accurate. It’s not any knock toward the Governor or the Executive Branch. It’s just that we have the benefit of our March 15th business tax returns. We have our federal tax returns on April 15th and our caseloads in May. That gives us a clearer idea of what it will look like in July. That’s what we set our budget on. If there’s any money left over, I would love to see it go into healthcare, whether it’s doctors, nurse practitioners, healthcare, or hospitals, whatever we can do to help that. There are also things for the hospitals, such as changing some of the licensing requirements that we can do to give them more reimbursement from the federal government. We’re looking at that, and it does not cost the State of Rhode Island anything. We’d get more money from the federal government.

But the problem is, to be quite honest with you, we don’t know what the federal government will look like. We don’t know. It causes a lot of angst. You’ve got to remember that many people are very nervous about what’s going on in Washington, but there are many people who are very happy about it, too. Many people love what’s going on [believing] we need to cut and everything else, and I understand that.

A lot of it right now is speculation, so I’m hopeful. I’m the eternal optimist. I want you to know that I love the State and want to stay here. I gave up my law practice to run this House of Representatives and am happy I did. I will continue to do it as long as my colleagues keep me there, and we’ll see what happens, but the point is, I’m the eternal optimist. There’s so much unlocked potential here in Rhode Island to improve it. I love our small size. I love that we can do things other states can’t do immediately. We can collaborate.

I’ll talk about business for a minute. No one’s brought it up, but we would lose IGT and Ballys, two major corporations. They were going to leave Rhode Island. We got them to stay and signed a 20-year contract with them to stay in Rhode Island. And it didn’t cost us a dime. They gave us more money because we’ve used our lottery contract with IGT and our casino licensing with Ballys to make investments here - to build new casinos, go online gaming, and do things to generate more revenue for the State primarily.

When it comes to the casinos, we have State-run casinos, but they’ve managed them and run them for us. We get 60 cents of every winning dollar at those casinos. 60 cents. That’s the highest in the country, higher than anything in Las Vegas or Atlantic City. We did very well, so we’re very happy about that. IGT is a great company. Both companies have a contract to be headquartered here and have employment minimums that, if they don’t meet, they write a check to the State. If we didn’t have those two companies here in Rhode Island, we’d lose many high-paying private-sector jobs.

When Massachusetts wooed Citizens Bank and was ready to walk out the door, we, as a General Assembly, with Megan’s help, sat down with them and reduced their tax structure to what it was. That’s a whole ‘nother story. People think we gave them some tax break. We returned them to what they historically had been paying. They were in a program they fell out of because of Covid requiring so many employees to work in Rhode Island because some people live in Massachusetts, Connecticut, and other places, and they work remotely. When they missed that goal, they fell out of the program; their tax increased significantly. Their taxes went from $10 million to $20 million. So we would just returned them to the $10 million. I’m using very round numbers, but I want you to make the point. We reduced their numbers, and we got Citizens to stay. And what has happened is they’re expanding here in Rhode Island and hiring more people - more high-paying jobs.

We’re working hard. We can expect a decision today, tomorrow, next week, next month, or maybe next year, but we’re also working very hard to keep Hasbro here.

People ask what companies we’ve gotten. I’m trying to keep the ones we have here. It’s the same thing with CVS. I know there’s a lot of talk about opioids and what they’ve done. They’re a Fortune Five company in the country, Fortune Five. We need to keep those high-paying jobs here in Rhode Island. They’re in a tax program and have indicated they’re very happy and want to stay here. They have a new CEO. I have a call with him next week. And I’m going to do everything I can to help CVS grow here in Rhode Island and grow not just in terms of pharmacy jobs, which are good, but also other jobs. They run Aetna Health. I’d like them to come into the market and offer more alternatives to consumers and hospitals with their reimbursements. They were based out of Connecticut. So that’s what we’re doing for healthcare.

Diane Hill: I’m here as the grandmother of two young children who grew up in Exeter, and what scares me long-term for them is climate change. I want to thank you for all the progress, Megan, that we’ve made in our State by lowering emissions and getting renewable energy going. I’m particularly concerned when you’re talking about housing and the building decarbonization bill. We haven’t done anything. Buildings are the second biggest emitter of greenhouse gases in Rhode Island. We are dealing with transportation, and that’s great, but we haven’t done anything with buildings. I would love to see the building decarbonization bill passed so we can at least start measuring the emissions coming out. As far as new housing, I don’t know, but I don’t see any reason why we can’t legislate that new housing has to be built electrified instead of with gas or oil. Economically, if you build it into new construction, heat pumps are comparable to putting in natural gas. Why would we build new housing that will contribute to emissions when we’ve got Act on Climate goals to meet? It doesn’t make any sense to me.

Speaker Shekarchi: It’s a great topic to end on because I feel very passionate about it. We passed the Act on Climate, a historic piece of legislation that set concrete goals over some time. We also have the earliest renewable energy goal in the country, 2033. California and the federal government are 2035. We’re working hard to meet those goals. We’ve done a lot of work to ban PFAS from food packaging. We’ve done a lot on renewable plastics. We’re going to continue. The decarbonization bill you’re talking about is Rebecca Kislak’s Bill. It’s a good bill. It just needs some more work regarding the size of the buildings. And that particular bill had two parts.

The first part you’re talking about, which everybody can agree with, is measuring what they do. However, the bill has a second part, a trigger that would dramatically escalate the construction cost. I told Rebecca that it was the second part we needed to work on, and to her credit, she is working very hard on it. She met with the Governor’s office. There’s a budget article about decarbonization - to start collecting the data. We’ve passed legislation, at least in the House, to make new construction electric-ready. It’s not a requirement, and I’ll tell you why. It comes down to support. I agree with you, but most people want to be able to build the house that they want. They don’t want to be mandated to build with electric heat or electric stuff.

You care about your children and grandchildren, like I was talking about housing when I knocked on those constituents’ door. We need to get more people thinking about the environment and the long-term consequences of it. I understand that. We’re going to continue to work so houses are electric-ready. All new construction will have a port to connectehicle to the garage if you have an electric car your electric v. We’re working on all of these things. It takes time and attitude.

We can discuss solar energy. We’ve done much historical work on it, including the Deforestation and Solar Sighting Acts. Now, we’re looking at bills. The League of Cities and Towns wants a bill that automatically allows solar on Superfund sites and old landfills; no local permits are required. I said, “Look, I’ll keep an open mind and bring it before us. I think it’s a good idea.”

We are number one in the country in terms of offshore wind. But again, offshore wind is a child, a vehicle, a protege of the federal government, and many federal tax credits are gone. This presidential administration has removed those. There are some people, most of it’s on the internet, who think offshore wind kills whales or dolphins or whatever. A lot of it is unsubstantiated. A lot of that is being funded by the opposition that remains anonymous. But the point is that it has worked on some people. If you talk to some people, they think offshore wind is terrible. So it’s an education campaign. It’s getting more people to understand and support your position. This is what I tell all my reps. This is what we have to do. We have to educate people and bring them along because when you start passing legislation mandating this and mandating that without a lot of buy-in or consensus behind it, people become very resentful, people don’t follow them, and they push back.

In my 12 years as a State representative, bringing people to the table is a lot easier. You try to bring them along to your position and educate them. Look, I’m a realist. I’m not going to get a consensus on every issue. I recognize that. But you mitigate the opposition, and sometimes you can meet in the middle where people don’t oppose it, and they gradually come along and understand.

So I agree with you. It’s just that many of these environmental initiatives are being driven by federal tax cuts and tax grants, and I don’t think they will be there anymore. They’re not going to be there for electric cars anymore. They’re not going to be there for offshore wind. We have to do our part in Rhode Island, but we recognize that we are the smallest state in the union. That doesn’t mean we shouldn’t try. That doesn’t mean we shouldn’t continue. And as I always say, especially about housing, just because it’s not easy doesn’t mean we don’t do it.