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Boston Globe
6 days ago
- Health
- Boston Globe
Primary care is in crisis — and Rhode Island can't delay addressing it any longer
Advertisement Primary care providers are being asked to do more than ever before: manage complex chronic conditions, integrate behavioral health services, address social needs, and navigate fragmented systems. But they're doing it with fewer staff, declining reimbursement, and an unsustainable administrative load — particularly prior authorization and denials that delay or block needed care. Get Rhode Island News Alerts Sign up to get breaking news and interesting stories from Rhode Island in your inbox each weekday. Enter Email Sign Up There are efforts underway. The Office of the Health Insurance Commissioner has taken meaningful steps to highlight the value of primary care. Governor Dan McKee and the Executive Office of Health and Human Services have included targeted investments in the state budget. Advertisement We can't fix this overnight, but we can take meaningful steps now. Increasing Medicaid rates, removing prior authorization barriers, and creating a safe harbor for physicians seeking mental health support won't solve everything, but they will keep more doors from closing while we work toward a better system. House Speaker K. Joseph Shekarchi and Senate President Valarie Lawson have both said that fixing health care is a top priority. Now we need to see that commitment reflected in action. Legislative and budget decisions made in the coming weeks will determine whether we're managing decline, or rebuilding the foundation we know we can't do without. This isn't just about physicians. It's about every Rhode Islander who has been told to wait six months for an appointment. It's about children overdue for physicals and older adults unable to refill a prescription. The erosion of primary care affects all of us — regardless of income, ZIP code, or insurance status. Rhode Island has the tools and talent to lead the nation in building a stronger, more equitable primary care system — one that respects clinicians, pays for what matters, and removes the bureaucratic roadblocks between patients and care. But we have to choose to act — and that time is now. The real fix will take time, funding, and the political will to follow through. But the longer we wait, the harder it will be to rebuild. If we don't act, we won't just lose practices — we'll lose the foundation of health care in Rhode Island. Advertisement Dr. Peter Hollmann is a board member of the Rhode Island Medical Society.
Yahoo
23-05-2025
- Business
- Yahoo
Should R.I. have more than one app to bet on sports? Study says yes, but only if change is made.
A computer monitor displays betting odds and promotions on FanDuel's website. Wagers are not currently allowed on the website in Rhode Island, though state regulators are now considering letting vendors such as FanDuel operate in the state. (Photo by Christopher Shea/Rhode Island Current) A new report commissioned by the Rhode Island Lottery recommends the state should add four to six new online sports betting vendors to boost its competitiveness with its neighbors, but only if it makes itself more attractive to popular companies like DraftKings and FanDuel. The report published by Spectrum Gaming Group on May 1 notes that there is no prohibition against increasing the number of authorized service providers beyond the one app currently managed by the gambling company that exclusively supplies the state's lottery equipment and technology. But when Rhode Island Lottery renewed its contract with International Game Technology (IGT) PLC to run the state's digital sportsbook, it was with a clause that the company would have the exclusive rights to handle all digital wagers through November 2026. State lawmakers have sought to end IGT's monopoly of Rhode Island's digital sportsbook, but such proposals were never going to head to the House floor this year. 'There is no need to adopt legislation this year because the state is under contract with the current vendor for another year,' House Speaker K. Joseph Shekarchi said in a statement to Rhode Island Current. Rhode Island Lottery, however, is now starting to consider upping the number of apps beyond the existing Sportsbook RI. Director Mark Furcolo informed the legislative committee that oversees the state's gambling sector on Monday that the lottery intends to issue a request for information (RFI) on the matter in early 2026. 'The purpose of the RFI is to gauge the level of interest in, and by which companies, providing a sports wagering product here and if not, why not,' Lottery spokesperson Paul Grimaldi said in an email. But companies may not be fully interested in expanding to Rhode Island due to its 51% tax on operators' revenues — which is tied with New York and New Hampshire for the steepest in the country. When the state inked IGT's initial contract in 2018, it was the only bidder to respond to the lottery's request for proposals. Spectrum suggests the state lower the tax rate. The report also recommends that the state allow online betting servers to be hosted outside of the state's two existing casinos in Lincoln and Tiverton — where any company would have to pay a 17% hosting fee to Bally's Corp. Such a change would require a constitutional change approved by Rhode Island voters. Spectrum's recommendations come as legislators have introduced bills this year to open up the market beyond the single app managed by the gambling company that exclusively supplies the state's lottery equipment and technology. The companion bills by Rep. Matthew Dawson and Senate Majority Leader Frank Ciccone would allow at least five sports betting vendors to open by July 1, 2026 — opening the door for companies such as DraftKings and FanDuel to take wagers in a state where they've been barred from doing so since the state first launched sports betting over five ago. Sports bettors have one app in R.I. More may be on the way. Ciccone's bill received its initial hearing before the Senate Committee on Labor and Gaming, which he chairs, on April 30. Dawson's bill was heard by the House Committee on Finance on May 1. Both were held for further study, as is standard for an initial vetting by a legislative panel. 'We need more competition,' Dawson, an East Providence Democrat, said in an interview. 'If you have a monopoly, you have no reason to innovate.' The state was the first New England state to legalize sports wagering in 2018, but neighboring Connecticut and Massachusetts have since entered the market and have only eaten away Rhode Island's revenue. Massachusetts, which launched online sports betting in March 2023, collected nearly $10.4 million in taxable revenue solely from wagers on the seven apps available there in just March of 2025. Connecticut, which has three sports betting vendors, brought in $21.4 million in tax revenue in fiscal year the same time period, Rhode Island saw $19.2 million in sports betting revenue transferred to the state's general fund. 'There's a significant amount of tax revenue we're not getting because we've decided we're going to let one company run the whole thing,' Dawson said. Fiscal notes on what Rhode Island could receive should it expand to five sports betting vendors have not been filed by the House and Senate. But Ciccone and Dawson point to Washington D.C., where wagers increased 172% in the last year after its Council approved expanding sports betting to additional platforms. 'That's significant,' Ciccone, a Providence Democrat, said in an interview. 'And with the problems we're having, why not try to bring in more players and see what we can do?' Ciccone was referring to the state's TK deficit heading into the fiscal year starting July 1, 2026. Along with additional revenue, Ciccone and Dawson argue that many users don't like the existing Sportsbook RI app. Dawson told Rhode Island Current he knows several bettors who go to the McDonalds in Seekonk, Massachusetts to place bets from apps other than IGT's. Lack of promotions and bonuses have made up many negative online reviews users have left on App Store and Google Play. Ciccone said his friend, the late Senate President Ruggerio, also had issues with the limitations of IGT's online sportsbook. 'He hated that app,' Ciccone recalled. Shekarchi said he has never used the app, but that he has heard both positive and negative experiences from others who have used it. IGT spokesperson Mike DeAngelis said the feedback the company receives tends to be positive. 'We work with the Lottery to ensure a great player experience with the Sportsbook RI app,' he said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
20-05-2025
- Business
- Yahoo
What slowdown? RI revenues revised up $80M despite recession fears.
Despite concern that the national economy is at risk of a recession, Rhode Island revenue collections have been revised up nearly $80 million for this year and next, according to new projections from state fiscal analysts. The latest projections, released Friday, May 9, show state revenue for the year ending June exceeding expectations by $60.7 million. And they predict revenue in the fiscal year starting July 1 to be $19.3 million higher than they expected last November. The rosier-than-expected revenue forecast will take some pressure off House Democratic leaders writing a state budget for next year by eating into what had been a projected $250 million budget deficit. Despite state revenues continuing to climb, General Assembly leaders remained downbeat, at least in part to discourage their members from demanding lots of new state spending. "The revenue results preview the effects of the weakening U.S. economy linked to turmoil in Washington, D.C., House Speaker K. Joseph Shekarchi said in an email. "Any short-term positive news is overshadowed by the magnitude of that uncertainty and the many related or unsolved budget issues." New Senate President Valarie Lawson and Senate Finance Committee Chairman Louis DiPalma said: "While we are pleased that revenue and caseload estimates remain relatively stable compared to the estimates made in November, we are experiencing a more challenging budget, and more difficult choices, than in recent years." The new numbers from the twice-a-year Revenue Estimating Conference expect current-year revenue to reach $5.6 billion on increases in personal income tax, corporate tax, utility tax, insurance premium tax, cigarette tax, alcohol tax, estate tax and lottery profit. The major exceptions to the upward tax revisions were sales tax, which is now expected to come in $22 million short of the November estimate, and bank tax, which is now expected to come in $27.3 million short of the November estimate. It was not immediately clear how much of the decline in bank tax collections, if any, were the result of changes made by lawmakers last year to help keep Citizens Bank in Rhode Island. At the end of April, economists from Moody's Analytics told the Revenue Estimating Conference that they expect the economy to slow in the years ahead and unemployment to rise, but stopped short of predicting recession. Looking forward to next year, the revenue estimators predict collections of $5.7 billion on a modest increase in personal income tax, insurance tax and lottery collections. They expect sales tax to continue to slide back next year. This article originally appeared on The Providence Journal: What slowdown? RI revenues revised up $80M despite recession concerns Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
12-05-2025
- Business
- Yahoo
Updated state revenue forecast: $80M ray of sunshine
State budget analysts now expect an extra $60.3 million in revenue to flow into state coffers by June 30, with a $19.3 million revenue boost in fiscal year 2026. (Photo by Christopher Shea/Rhode Island Current) The state's precarious financial situation is looking slightly more sturdy. An extra $60.7 million is now expected to flow into state coffers by June 30 under new estimates adopted by state budget crunchers Friday. The rosy conclusion to the biannual Revenue and Caseload Estimating Conference also projected $19.3 million more revenue for fiscal 2026. The combined $80 million projected revenue increase for this year and next shaves nearly one-third off the expected $250 million budget deficit. Which leaves lawmakers with a $170 million spending gap to close — not insignificant, especially against the backdrop of potentially devastating federal funding cuts and warnings of a 'recession-adjacent' economic slowdown. Indeed, House Speaker K. Joseph Shekarchi's reaction to the updated revenue numbers Friday was not exactly celebratory. 'The revenue results preview the effects of the weakening US economy linked to turmoil in Washington, DC,' Shekarchi, a Warwick Democrat, said in a statement. 'Any short-term positive news is overshadowed by the magnitude of that uncertainty and the many related or unsolved budget issues.' Senate President Valarie Lawson, an East Providence Democrat, and Senate Finance Chairman Lou DiPalma, a Middletown Democrat, also referenced the uncertainty of federal funding in a joint statement reacting to the updated state revenue estimates. 'We remain committed to passing a balanced, responsible budget in time for the state's new fiscal year, which begins on July 1, and if subsequent developments in Washington necessitate additional action, we will be prepared to address that at the appropriate time,' they said Friday. Yet the latest state forecasts suggest revenue is rising across a wide array of tax sources. Personal income taxes, which account for one-third of the state's $5.6 billion annual revenue forecast, are now expected to come in $37.1 million higher by June 30, with an extra $10.1 million in fiscal 2026. The state is also poised to bring in more money through lottery taxes (up $15.4 million over the next two years combined) along with taxes on public utilities, insurance companies, and cigarettes. These gains will be partially offset by less-than-expected income from sales and use taxes, trimmed by $22 million in fiscal 2025, and down another $37.1 million in fiscal 2026. The state also won't be generating as much revenue from taxes on bank income; the expected $12.3 million fiscal 2025 revenue from financial institutions taxes is one-third of the $39.5 million forecast six months ago. In response to state budget analysts, the Rhode Island Division of Taxation said it initially thought additional taxes paid in 2023 reflected an increased tax liability for 2024, when in fact the elevated 2023 returns were the result of overpayments. How much of the loss in expected bank tax revenue reflects a change to state tax code enacted by lawmakers in June at the request of Citizens Bank was not immediately available. The controversial tax rewrite, which took effect Jan. 1, was expected to reduce fiscal 2025 revenue by $7 million, rising to $15 million for the full fiscal 2026 year, based on the lower tax bill for Citizens. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Boston Globe
04-04-2025
- Politics
- Boston Globe
$510m funding cut for Brown University would have ‘a ripple effect throughout our economy,' R.I. officials said
Get Rhode Map A weekday briefing from veteran Rhode Island reporters, focused on the things that matter most in the Ocean State. Enter Email Sign Up Related : Advertisement Rhode Island House Speaker K. Joseph Shekarchi, a Democrat who has championed the state's life sciences efforts, told the Globe that a $510 million cut 'will have a ripple effect throughout our economy.' Brown is 'a strategic partner in the life science efforts that we just started and were seeing some very, very good results,' said Shekarchi. 'This could be a setback. I am concerned.' Brown is the fifth university to face a potentially dire loss of federal funding. On Thursday, the Trump administration's antisemitism task force sent Harvard University a Advertisement Maey Petrie, executive director of the nonprofit 'The long-term effects on scientific innovation are hard to overstate,' said Petrie. 'The administration may not fully grasp the damage being done for years, but from where we stand, it's already clear: research pipelines are being choked, momentum is being lost, and crucial health equity work is being deprioritized.' Brown University officials had not been informed of the cuts on Thursday night, even as news reports based on information from unnamed sources were published by The Daily Caller, The New York Times, and Bloomberg. US Congressman Seth Magaziner, a Rhode Island Democrat, told the Globe he spoke to Brown president Christina H. Paxson by phone on Thursday. 'She hadn't actually received any official communication from the administration with any specifics,' he said. In a message sent to university officials Thursday evening and obtained by the Globe, Provost Frank Doyle said Brown was aware of 'troubling rumors emerging about federal action on Brown research grants,' but that officials had 'no information to substantiate any of these rumors.' Advertisement Some members of Rhode Island's congressional delegation are expected to meet with officials at Brown on Friday, according to a congressional staffer with direct knowledge on the matter. Representatives for the Trump White House and the US Department of Education did not respond to the Globe's requests for comment. Meanwhile, Brown University students said the Trump administration's cuts, made in the name of protecting them from antisemitism, did not make them feel any safer. 'As a Jewish student, I do not feel this makes me safer in the slightest,' said Andrew Rovinsky, class of 2025. 'Brown is not a perfect place when it comes to antisemitism, but I have never felt unsafe on this campus and in this community and have always felt free to express myself publicly as a Jewish student. The trump administration is, in my view, weaponizing antisemitism to repress dissent and scholarship that it disagrees with.' 'This is not about Jewish students, but the trump administration's political agenda,' he added. 'I am a proud Jewish student at Brown, and I fully reject the slashing of funds in the name of combating antisemitism,' said Canaan Estes, class of 2028. 'I feel safer in spaces of academic engagement and open dialogue, not censorship and fear.' Others noted that antisemitism exists at Brown, but the university has worked to combat it. 'At a university where nearly a quarter of the students are Jewish and Jewish life thrives, it's difficult for me to see what could warrant such a response from the federal government,' said Eli Williams, member of the class of 2028. Advertisement Maya Rackoff, class of 2025, agreed. 'The Trump administration is going about it in a counterproductive and authoritative way, infringing upon real and perceived academic freedom,' she said. 'The most ironic part about cutting Brown's funding is that the Brown administration has been uncommonly strong in supporting Jewish and Zionist students, and Jewish life has thrived here over the past year and a half.' A pro-Palestinian encampment at Brown University in Providence, R.I., on April 24, 2024. PHILIP KEITH/NYT The Trump administration has targeted colleges for their handling of antisemitism after the Oct. 7, 2023, attack by Hamas on Israel and Israel's subsequent war against the militants in Gaza. In late 2023, more than 40 student activists led by the Brown Divest Coalition Still, the US Department of Education's Office for Civil Rights opened an investigation in 2024 into whether Brown's administration failed to respond to incidents of alleged harassment against students with Jewish ancestry, which would have violated Title VI of the Civil Rights Act. In a July 2024 resolution, Brown denied it violated Title VI but agreed to expand nondiscrimination trainings and other measures, including 'ongoing monitoring.' Advertisement The initial complaint that launched the investigation was filed by Zachary Marschall, the editor of Campus Reform, a conservative news organization focused on universities. Campus Reform has filed several lawsuits alleging antisemitism, arguing that schools 'failed to protect students of Jewish heritage following the Oct. 7, 2023 attack.' In March, Brown was one of 60 universities that received a letter from the US Department of Education, warning it could face 'enforcement actions' if they failed to 'protect Jewish students on campus.' 'That support is a privilege and it is contingent on scrupulous adherence to federal antidiscrimination laws,' Secretary of Education Linda McMahon said at the time. Pro-lestinian protestors rally as they march around university hall at the pro-Palestinian encampment at Brown University as they await answers from their delegation who are meeting with school leaders on campus in Providence, Rhode Island, on April 29, 2024. JOSEPH PREZIOSO/AFP via Getty Images For the first time since 2002, Brown has hired firms to lobby Congress and the Trump administration on its behalf. Representatives from Cornerstone Government Affairs and AxAdvocacy, which touts its Even with federal funding on the chopping block, Brown is unlikely to get help from the state. For the last few years, Brown has requested millions in a state budget appropriation to support cancer research. They've never received the funding, and Shekarchi said Trump's latest proposed cuts 'doesn't change my mind at all.' 'It's very hard for my caucus to support Brown University, because there's such a very large endowment,' said Speaker Shekarchi. 'And we have state universities who have just as much of a competing need. " 'Everybody needs help. Everybody's getting cut. The health department's getting caught. Right. The Department of Education's getting cutting,' said Shekarchi. 'Sadly, elections have consequences. And we're going to see a lot more of this.' Advertisement Sofia Barnett, a Globe correspondent and Brown University student, contributed to this report. Alexa Gagosz can be reached at
