- The governor, as if he doesn't have enough problems, already being down 20 points.

His own Democratic town committee in Cumberland, ouch, endorsed Elena Foulkes, is it over?

Is it toast, should we stick a fork in his campaign?

- We have railroaded through all of these policies that eliminate or cut red tape to spur more housing production.

I don't really see those bills as having an impact.

- There might be housing fatigue.

- I think it's fair to say that everyone's premiums who fall under these groups is gonna have to pay more next year.

- But at least double digits and in some cases, 30%?

- How much does the state wanna step in and fill that gap?

(upbeat music) - And welcome into this edition of, "Lively," I'm Jim Hummel, joined this week by Rhode Island, current senior reporter, Nancy Lavin and Providence Journal State House Reporter, Patrick Anderson.

Some of you will be in for a big sticker shock next year on your healthcare premiums, and most of us should see a significant, if not eye popping increase.

For years, state leaders have been warning us about a healthcare crisis in Rhode Island.

Is it on our doorstep?

Nancy, it seems like you have the insurance Commissioner, Cory King on speed dial these days.

You had a great article for The Current just about, I think there's a confluence of things catching up, including the federal cuts, but also, a lot of people have dropped their healthcare insurance.

So dive in where you want.

- Sure, so I will say Cory King puts his cell phone at the bottom of his email address, so this isn't my personal accolade.

Cory King just makes himself very accessible to reporters, which we love.

Commercial insurers filed their annual rate requests with the office of the Health Insurance Commissioner, which starts this several month process of public hearings.

And the AG is gonna have someone come in and say why it's not good for people's affordability to raise premiums.

As expected, all the insurers want to increase their annual premiums for this covers about 140,000 people who either buy insurance through the marketplace or have an employer health coverage plan.

The rate proposals are almost, but not quite as high as last year, which last year they were the highest in a decade.

They're not final, Cory King's probably going to shave some off, but I think it's fair to say that everyone's premiums who fall under these groups is gonna have to pay more next year.

- But at east double digits, and in some case, 30% at that?

- Yes, United Healthcare for its large employer group filed a 34.9% year over year increase, which Cory King said he's never seen a 30% plus increase.

- Wow.

- Yeah.

- I mean, not a lot has changed, it's a crisis, but a crisis that's been happening and is ongoing.

The cost of healthcare continues to rise.

Inflation is hot and it needs to be paid for either through premiums or through subsidies, taxes, or you have hospitals going under, which we just had a bout of.

So there's no way to really get around paying for it.

I mean, I think the question I have, and maybe Nancy has insight into this is, what is the ability of the insurance commissioner to tell the insurers, "No, take a haircut, no increases, you just eat it all."

That would end up in court, how would it wind up?

I don't know.

- He does not have that ability.

I will say that the budget, that lawmakers just passed includes some extra sort of enforcement provisions for the health insurance commissioner to set caps on how much overall we increase healthcare spending every year, because right now it's a voluntary cap and everyone just blows past the cap every year.

But by law, the health insurance commissioner has to keep insurance companies financially solvent.

And I think one of the things I have learned or found interesting in covering this, in talking to Cory, is that I think insurance companies are often vilified and perhaps to some degree, rightly so for, oh, they're just trying to like pad their bottom lines.

But their own costs are going up, and then what happens is if they don't have enough money through premium increases and other sources of revenue to offset the increased cost of GLP1s and healthcare services and claims by patients, they are not going to be able to pay the hospitals and doctors that we all see enough that those doctors and hospitals will stay in business and even continue to take that health insurance.

We've seen that, again, Brown University Health has not been able to reach a contract agreement with United Healthcare for Medicaid Medicare Advantage patients.

And that's because the two groups, Brown Health wants more money and United Health says, "We don't have the money to give you for providers."

And the people who lose in the end are the patients.

- But to your point, it's interesting 'cause Peter Neronha's been beating this drum, don't give them anything, zero, which you can't do.

And it's kind of the same with the Public Utilities Commission when it comes to- - Well, has it ended up in court?

I mean that's, he's a lawyer, this is a legal issue.

The question is, if someone, if the insurance commissioner did that, how would it play out in court?

- There is a judicial appeal process that.

- It hasn't even tested, what, I mean, let's see it.

I mean we're kind of just curious.

- Yeah, but at the end of the day, would you eventually go through all of that time, effort, and money, and then they would still have to give them the increase.

- And there hasn't been appeals because Cory King has shaved substantial money off of in general what health insurers have wanted, but has not said no increase.

- It's the carrot rather than the stick.

Because the stick is the judicial route.

But I'd be interested too, to have a test case.

Maybe not at this point.

The other thing too is, and we've seen this with what's going on in the federal government, if you're in the exchange with HealthSource Rhode Island, a lot of people got sticker shock.

We talked about that the premiums coming due the beginning of the year, they're just dropping their insurance.

And so insurance always been based on young healthy people subsidizing the rest of the old guys, right?

Who begin to have more healthcare.

And if you're losing those, then their bottom line is suffering too.

So isn't that part of the cycle?

- It is and there is expected potentially to be some relief there because the, again, the state budget includes about $20 million to offset the higher premiums for middle and low income Rhode Islanders who want to continue to or come back to the health exchange.

But that doesn't start until January.

- And the federal Medicaid cuts are ramping up.

We really even haven't felt the bulk of those yet.

So next year, the year after, there is gonna be increasing debate and pressure on the state budget.

- And that was by design in Washington, right?

Let's wait until after the election.

- [Patrick] Yes, there's a midterms coming up.

- Yeah, yeah.

And so what, so continue that.

- Oh, so there's gonna be, when we go into the budget next year and the year after, of how much does the state wanna step in and fill that gap?

And that, to be determined.

- The larger picture about primary care doctors and reimbursement, you can go to Massachusetts.

Did the general assembly address any of that this session?

- Well, there is a rate review also coming out from Cory King's office in September, which is going to recommend most likely increases to our Medicaid reimbursement rates for primary care providers.

And one of the factors there is like retention and competitiveness with neighboring states.

Knowing that that is coming, I think lawmakers, again, there's just no, there's really no money to give primary care providers the Medicaid reimbursement rates that they want.

So for now it's kind of like, oh, we're gonna wait for Cory King's recommendations to come out.

They did put in a little money for a URI medical school.

They did some loan forgiveness for primary care workers who study and then stay in the state.

But no big moves.

- The most interesting debate and thing was what didn't happen.

There was a bill trying to attack this thing, concierge medicine, which I don't know a ton about, but are I guess are either sort of Wall Street backed firms coming in and buying up practices and you have to pay a fee, a very large fee to access these doctors.

And there's a lot of hand wringing about doctors sort of leaving the publicly accessible that where patients can publicly access them into these very private groups.

- They're getting paid off, they're getting paid off to do it.

- Yeah, and so there was a bill to try to crack down on this, not really crack down it, but let independent physicians pay fees or charge fees themselves, so in a kind of middle ground where they didn't go up to these huge 20,000, $80,000 fees.

That passed the house, didn't pass the Senate.

- Passed the Senate.

- It died.

- The study that the commissioner is doing, was that the thing, remember the governor, I've heard him in interviews say, people would say, look, they're making so much more in Massachusetts, Connecticut, he says, "I don't see any of that, we need to do a study on it."

Is that where it came from that, I mean, your eyes and your checkbook tells you otherwise, but the governor said he needed data.

Are those working together, the governor and the insurance commissioner, or was he gonna do that anyway?

- Yeah, I think Cory King is part of, his office falls under the administrative arm of government.

There are, he's been doing these, a series of rate recommendations.

The budget that just passed includes increases that were recommended by Cory King's office for home healthcare and behavioral health providers.

So we're kind of tackling this in pieces with different types of providers and primary care is kind of the big one that everyone's been waiting for.

- Finally, when will we know the premium, it's for next year, so over the course of the fall, we'll find out?

- Usually by early September, there will be, there's a couple of public hearings and administrative hearings over the summer in July in case you don't wanna go to the beach and wanna go to the Public Utilities Commission and talk about health insurance.

- [Jim] And hang out with you.

- And usually by September, Cory King will issue a decision of this is what we're allowing and it's often less than what insurers wanted, but it's not gonna be, it's highly unlikely it's gonna be zero.

- We'll be reading your story when it comes out.

All right, we'll keep an eye on that.

Governor McKee signed next year's $15.2 billion budget into law last week in plenty of time for the new fiscal year.

So who were the winners and the losers?

You guys, well the winners were you guys, because you didn't stay up until four in the morning.

You even, what time did you get out the last night?

- Or were we?

Or are we looking for that drama and we don't have it anymore?

And we need it!

- Hey listen, I remember back in the day walking out with Kathy, Greg and the sun came up and we were smoking cigarettes in the parking lot.

Those were the good days.

- Well that was an early night 'cause I remember leaving and the sun had been up for three hours.

So it was almost lunch.

- Beware what you long for.

You were out before, well before midnight this year, right?

- Yeah, actually, well, the house broke one minute before midnight.

I don't know if the speaker was watching his watches and just, that was a flex to go right before the clock struck 12, but it was very controlled, there was very little drama.

The big issues had been settled weeks, if not earlier before the usually chaotic end of the session.

Things like the millionaires tax in the budget and Inspector general, which no one really saw coming at the beginning of the year, a deal on clergy sex abuse.

Litigation, legislation, those were the headline things.

And those were all negotiated well before the usually chaotic rooms filled with smoke and backroom deals sort of things happen.

Yeah, so we had it easy in that respect.

- Yeah, I was covering the Senate this year while my colleagues were in the house and it was boring, even surprising that there just weren't very many floor amendments.

The one sort of, one of the deals that was, worked out at least, appeared to us to be worked out a few days before session was, is this three year moratorium on new charter schools.

There was a floor amendment on the last day of session by the Republican senate minority leader, Jessica de La Cruz that would've exempted this one Providence bilingual charter school, La Comunidad from being part of the moratorium.

And it failed pretty narrowly.

There was democrats.

- By legislative standards, right?

- Right.

Well, I mean there was the Republicans, there was some progressives, there were some moderates.

It seemed this is an issue that has really crossed party lines in a way that we don't always see, but that failed.

And other than that, there weren't even really amendments introduced that were anything of substance.

It was just like next, next, next.

They went through an 80 item calendar in I think two and a half hours.

- Wow.

And the charter school moratorium, I still hear the ads on the radio.

That's one thing outstanding.

We think the governor, we think he's not gonna take any action on it, right?

- That's what the strongest odds are that it becomes- - But there's still a window for the veto, right?

- Yes, it's on his desk right now.

He could veto it or he could let it become law without his signature.

That latter option is probably the most likely at this point.

But it's definitely not an easy decision for him or a comfortable place to be politically because of his longstanding support for charter schools.

And he, in his first year, he threatened to blow up the state budget over a charter school moratorium.

I mean he went beyond just threatening to veto it, I mean he was really, really adamant about it.

- But the metamorphosis, I mean, I remember I interviewed him when he was the mayor of Cumberland and he was bringing people in 'cause he wanted to start the charter school there.

And then the fact that Bob Walsh and the NEA, I mean he needs the union support now, but that metamorphosis over the last 10 years, some would say it's political.

Maybe it's just good politics for him, I don't know.

- Yeah, I mean I think what it is is this is an election year.

His odds are very low at this point at best.

So he needs the teacher's unions if he has a shot and the teacher's unions want a charter school moratorium.

- Let's talk about some other stuff that didn't make it.

The medical assisted suicide, which seemed to be getting a little bit of, or was that just a lot of sound and fury and it wasn't gonna go anywhere.

- I heard a few things like through the grapevine that, oh, maybe it might get some traction this year, but then it just kind of fizzled out, it wasn't really a dramatic end.

I would say the more dramatic end was the decision by legislative leaders and Secretary of State, Gregg Amore, on four days before the end of session that we're not going to advance a state voting rights act to sort of enshrine voter access, any equal treatment in the face of not really having those federal protections anymore.

- [Jim] Why?

- I think it's kind of one of those devils in the details.

A lot of people weighed in with little bits and bobs of either legal or technical concerns and they just kind of ran out of time to fix it.

And I think to that end, there was just, it appears not an appetite to do what they have done in the past, which is on the last night of session, as we saw with the assault weapons ban last year, spend hours behind closed doors figuring out a deal and working out these frenzied floor amendments to come up with something that everyone felt okay about.

- And there, with that one, and I have not dove into the details of the various language things that were being fought over.

There isn't a practical, immediate thing that's gonna happen.

I mean, redistricting would be the major thing that this could possibly practically affect.

And it's not, we're not gonna have that until 2032?

- Yeah, it's gonna be, Kimball Brace will be back again, I'm sure.

- I haven't heard that name in a long, long time.

- Yeah, I just pulled it out of nowhere.

Patrick, let's stay with you.

You had a great article about housing.

This has been the Speaker Shekarchi's main thing.

He's off to the side now and I wonder, we won't know maybe until next year, but I wonder whether housing is gonna continue to be a priority for the new speaker and what happened to the bills that were pending this year?

- Well, there were a lot of them, and they go- - Introduced by the former speaker, right?

- Yes, and he did, compared to prior years, he did not get the percentage of bills he usually... Usually, those things get through, those are his top priority, and he makes sure of that.

That didn't happen.

He got one significant one that I will not try to even describe.

It is incredibly in the weeds, but it has to do with how towns can block housing projects and change things.

But yeah, there might be housing fatigue.

There's been a lot of talk about housing policy, a housing crisis and that we need to do something about it.

And it's possible that it's that politically, other things have pushed it to the side a little bit.

And we don't know what Speaker Blazejewski's niche will be.

We don't know as much to the same degree we did with Shekarchi, of what he's really interested in.

- Do you get a sense?

Well we know the Inspector General and did that surprise you, when he said Inspector General?

- I mean it did just because it's, I've covered that every year at Rhode Island Current and it's always kind of- - And you know it's going right in the dumper.

- Yeah, it's like kind of an interesting, from a policy perspective, like there's an argument for it, but then Shekarchi's argument was always like, well it's redundant because we have an office of internal audit and we have an auditor general and we have an attorney general.

And I think there's potentially merits to that counter argument as well.

It's hard for me to know, like Patrick said, what Blazejewski's priorities are gonna be.

I don't think he's going to make housing his priority just because I think there's fatigue.

And I think there is, to me even, a little bit of a question of, we have railroaded through all of these policies that eliminate or cut red tape to spur more housing production.

And I understand it's like a long game, not a short game.

But the municipalities are not into it, they're not doing it and we're not really seeing, I think from those bills versus other just market forces maybe are easing the housing crunch a little or supposed to.

I don't really see those bills as having an impact.

- Well, I mean there has been a lot passed, but compared to other states, it has been very incremental and it's been very small boy.

That was Shekarchi's approach was to take this very gradual, lots of little small changes.

Other states have done a lot more on housing and been much more aggressive on forcing development.

- The Rhode Island Public Expenditure Council of course had a report a couple of weeks ago.

They do great work on a variety of issues.

And they said really for what we've spent, we're not getting a lot, we're not anywhere near our goals for 2030.

Of course the spokesman for housing said, "No, no, no, we're gonna make it in the next four years."

I don't know about that.

But for the money we spent and more bond, we've had two bond issues now, plus 250 in the ARPA money, we're not getting a lot back from it.

- Yeah, I think and RIPEC has issued these reports before in years past about sort of the efficiency of government spending.

Their of course line in general is that we're spending too much relative to our revenue growth.

But I think there's also a more nuanced take about what are we getting for our money and on housing, I think it is hard to expect or to know how to quantify the investment should yield this many units, but their analysis shows what we're getting for what we're spending is pretty low.

- Yeah, and Providence is, oh, we've got a lot of permits issued, we may not have people in the housing yet, but they're in the pipeline, so maybe give it another year.

I don't know.

- The amount of building permits has been tracking up.

So there has been an increase, but we are spending a lot of money.

How does that net out?

I don't know.

And then there's, we always wonder what is the affordability level?

The more you subsidize, the more you spend to make each unit cheaper for rent, the more the taxpayer contributions.

So there's that kind of juggling of... - Last topic, you've covered the Coastal Resources Management Council.

There's been a push, let's get it under maybe the executive branch.

There was law last year about maybe getting some people who actually know something about the coastline on there.

The governor makes appointment.

So the legislation goes down, but the governor this year, but the governor makes appointments, all men and some people who are controversial, like the longtime chairman who's been there forever.

What do you sense?

Is that... - I mean, I think that the people who are critical of the CRMC are gonna keep being critical and the people who don't want to deal with the administrative and potentially financial hassle of rejiggering it are not going to want to.

And Shekarchi was a big defender of the CRMC in its existing structure, noting that he was at one time, a member of the CRMC.

- [Jim] Oh wow.

- I will say even for my own kind of personal skepticism about, is putting, reshaping the council and adding a few qualifications and putting a few new faces on there, is that really gonna do anything?

Their most recent meeting, which was a big decision for this newly appointed panel about something to do with the South Coast wind cables that are gonna go under the Sakonnet River, it was evident to me, having watched and covered a lot of those hearings, these new council members understand the technicalities of this a lot more than, or maybe they're just less tired that, there's that.

But the questions they were asking of the developer, of the staff, of the opponents were very, made it very clear they understood and perhaps even more than what was being presented to them, the nuances of this technical stuff.

Whereas the old council members didn't ask a lot of questions, or if they did, the questions weren't super technical in nature.

- They relied on the staff.

Let me shift to the governor's race.

The governor, as if he doesn't have enough problems already being down 20 points.

His own Democratic Town Committee in Cumberland, ouch, endorsed, Elena Foulkes.

Is it over?

Is it toast?

Should we stick a fork in his campaign or what are we doing here?

- I mean, I can't, I do not have a fork, I don't stick to anyone, it's not for me to do, but it doesn't look great.

He is going to try to bloody her and CVS, a very large employer this summer.

I don't know if that is gonna be enough.

And I don't know if there is more opposition research or any surprises along the way.

Barring that, it's a difficult path.

- Our colleague, Dan McGowan at The Globe said, well, next week is the filing deadline.

We'll be talking about that on next week's Lively, who's in and who's out.

It's not too late for the governor to pull out and Joe Shekarchi to jump in, which I think is probably a 2% chance, but it's this- - It would be the funniest thing though.

- Wouldn't that be great?

- You have to admit.

- Never mind about that Supreme Court thing.

I'm coming in, I got $4 million, you're gonna see Joe Shekarchi all summer.

- That would give us the excitement we were missing.

- Can you imagine all that stuff?

He's like, "Hey, you didn't get it in the legislative session, I'm back."

A lot of headwinds for the governor at this point.

- Yeah, I mean I think there's optics and then there's actual performance in the primary.

I spoke with a couple of political analysts after the governor snub by his hometown Democrats.

Embarrassing, yes.

Do average voters know who the Cumberland Town Democratic Committee is?

Care who they supported, understand even the embarrassment or will that influence their vote?

Most political observers say probably not.

- But you also wonder if that's reflective of a larger feeling that because, I saw interviews with the people say, look, we just don't think he's... In my words, we don't think he's getting the job done, we think it's time for change.

And whether if the Democrats and public are in Cumberland are feeling that way, what about the ones in Narragansett, Westerly and Newport?

- And we know that they are, or we know that at least some of the other ones are Portsmouth and Johnston Town Democrats also endorsed Foulkes over McKee.

The Association of Democratic City and Town Shares also endorsed Foulkes over McKee.

But I don't know that like municipal party bosses is really like what shapes the outcome of a primary.

I do think if McKee can get the teacher's unions behind them and they really do a lot of legwork over the summer to whip up support, that might help him.

But the other thing is, he's not in a four-way primary this year.

He's in a two-way primary, so he's going to need more than 30% of the vote to win.

- It's not the norm, it's the indicator.

It's the sitting governor is having that kind of trouble convincing party officials and, and members of the establishment who should be in a normal year, behind him and would normally endorse him.

It's just an indicator.

And will the state part, the state committee which is about to endorse, will they take the very unusual step of endorsing a primary challenger?

- [Jim] To an incumbent governor.

- To a sitting incumbent governor?

- Alright, let's do outrageous and or kudos.

Nancy, let's begin with you this week.

- My kudos is to my alma mater, University of Rhode Island, which is doing an excellent job of marketing the corpse flower bloom.

The live stream, very fun to watch, entertaining.

Yeah, it's a fun little viral moment.

And hats off to URI for making like sort of a wonky and apparently I haven't been there but stinky environmental event into something that is getting clicks and maybe like donations to the university.

- [Jim] Our own Isabella Jibilian on Ocean State Media, you can see it online.

She did a piece, so if you wanna see it, it's not smell-a-vision, but you can at least look at it and think about how smelly it is.

- Was the line longer to get to the corpse flower or the Justin Bieber thing in Newport?

- Oh yeah, Haley Bieber, right?

- That's an outrage.

- Nevermind.

Well, I stole, I partially stole my own thunder, but I'll do it in a kudos.

I mean, I think it is a positive that the general assembly is not passing bills out of smoke-filled rooms at 3:00 AM that no one's ever heard of, that clearly were special deals for some lobbyist or a particular friend.

And that they're not going till the middle of the night.

Even if it does rob us of some drama and some copy, it's probably better for democracy that they don't do that.

- All right, now I normally don't do an outrage, but I will throw mine in, playing off what you said.

Dave Del Pollo photographer at the journal, he got a shot of a Del's' cups presumably in the Senate Chamber on the last night.

And you see what's in that cup?

There's a spoon in that cup.

My recommendation would be that that senator be censured.

I don't know whether that's gonna be... You don't think that's that big a deal?

- There should be hearings.

- Definitely.

- The legislature has a lot bigger problems to worry about.

- This is what I focus on.

I'm not worried about the healthcare and the CRMC, I worry about the spoon.

That's my 2 cents.

All right, Nancy and Patrick, great to see you.

Thank you for joining us.

Be sure and check us out on Facebook, X, Instagram, and on the Ocean State Media YouTube channel.

And once again, wherever you get your favorite podcast.

We'll see you next time right here on "Lively."

(upbeat music) - [Announcer] Lively is generously supported in part by John Hazen White's, "Lookout."