RI H7466

Establishes the Rhode Island Individual Market Affordability Program to provide state-funded premium assistance and cost-sharing subsidies for low- and moderate-income residents purchasing health insurance through the state exchange.

Creates an income-tiered premium assistance structure where households up to 150% of the federal poverty line pay 0% of income toward premiums, scaling up to 8.5% for households at 400% FPL and above.

Requires a minimum state appropriation of $59.3 million if federal premium tax credits become less generous than the original ACA amounts established as of July 3, 2025.

Authorizes the exchange director to seek additional funding through Section 1115 Medicaid demonstration waivers, Section 1332 state innovation waivers, and other federal sources.

Restructures the exchange advisory board to include 14 voting members representing health insurers, healthcare providers, advocacy organizations, hospitals, businesses, and consumers.