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State Laws

Rhode Island


Political Information

Executive (Governor)

Pro-choice

Senate

Mixed-choice

House

Mixed-choice

Abortion-Care Policies

Abortion Providers

Abortion Providers: Restrictions

Rhode Island imposes extra restrictions on abortion providers, despite the fact that all health-care providers already must comply with a variety of federal and state regulations governing health, safety, building and fire codes, and zoning requirements.  

Restrictions on Where Abortion Services May Be Provided

Rhode Island places medically unnecessary restrictions on where abortion services may be provided.

Any abortion providers-including private physicians-must comply with a uniquely imposed licensure scheme not required of other medical providers. 216 R.I. CODE R. § 20-10-6.3. (Enacted 2002).

Rhode Island requires that abortion services provided up to 14 weeks outside of a hospital have "hospital emergency back-up services" available.  For procedures between 15 and 18 weeks, the state requires they be provided in a hospital, a licensed freestanding ambulatory surgical center, a licensed physician’s "office operatory," or a freestanding surgical facility.  After the 18th week, abortion services must be provided in a hospital or ambulatory surgical center. 216 R.I. CODE R. § 20-10-6.3. (Enacted 2002).

Restrictions on Who May Provide Abortion Services

Rhode Island prohibits certain qualified health-care professionals from providing abortion services.

Only a physician licensed by the state to practice medicine or osteopathy may provide surgical abortion.  216 R.I. CODE R. § 20-10-6.3. (Enacted 2002).


Abortion Providers: Expanded Access to Non-Surgical Abortion

Other licensed health-care practitioners acting within the scope of their practice may provide medication-abortion services.  216 R.I. CODE R. § 20-10-6.3 (Enacted 2002).


Abortion Rights

Post-Viability Ban

Rhode Island law protects the right to abortion before fetal viability and states that an abortion may be provided after viability when necessary to preserve the health or life of the pregnant person. 23 R.I. Gen. Laws Ann. § 23-4.13-2 (Enacted 2019).

NARAL Pro-Choice America supports the legal framework established in Roe v. Wade. Regarding the right to abortion in the third trimester, Roe allows for restrictions on post-viability abortion so long as they contain adequate exceptions to protect the woman’s life and health. However, many states have bans with inadequate exceptions, no exceptions at all, or define viability as occurring at a particular point in pregnancy. A state may not prohibit abortion prior to viability, which is that point at which a fetus is capable of "meaningful life" outside a woman’s body. Roe v. Wade, 410 U.S. 113, 163 (1973). Because viability is a point that varies with each pregnancy, states may not declare that it occurs at a particular gestational age. NARAL Pro-Choice America does not oppose restrictions on post-viability abortion, such as Rhode Island’s, that contain adequate exceptions to protect the woman’s life and health.


Protections: Freedom of Choice Act (FOCA)

Rhode Island has created additional protections for reproductive rights by adding an affirmative right to choose into its state law. This law ensures women’s access to pre-viability abortion services and would remain in effect even if Roe v. Wade were overturned.

Additionally, the law protects the right to prevent, commence, continue or terminate their pregnancy prior to fetal viability. The law also protects the right to access and use contraception and abortion.

"(A) Neither the state, nor any of its agencies, or political subdivisions shall:

(1) Restrict an individual person from preventing, commencing, continuing, or terminating that individual’s pregnancy prior to fetal viability;

(2) Interfere with an individual person’s decision to continue that individual’s pregnancy after fetal viability;

(3) Restrict an individual person from terminating that individual’s pregnancy after fetal viability when necessary to preserve the health or life of that individual;

(4) Restrict the use of evidence-based, medically recognized methods of contraception or abortion except  in  accordance  with  evidence-based  medically appropriate standards that  are  in compliance with state and federal statutes…" (5) Restrict access to evidence-based, medically recognized methods of contraception or abortion or the  provision of such contraception or abortion except in accordance  with evidence-based  medically appropriate standards that  are  in  compliance  with  state  and  federal  statutes…"  23 R.I. Gen. Laws Ann. § 23-4.13-2 (Enacted 2019).


Biased Counseling

Biased Counseling

A woman may not have an abortion until after a physician or physician’s agent informs her of the gestational age of the fetus and the nature of the proposed procedure and its material medical risks, and she signs a form that includes the statement:  "If you decide to carry your pregnancy to term but not to keep the child, you may be able to place the child with either a relative, or with another family through foster care or adoption." R.I. Gen. Laws Ann. §§ 23-4.7-2 to -4.7-5 (Enacted 1982).

With respect to a previous version of this law, a court held that the requirements that a woman be informed of the nature of an abortion and the gestational age of the fetus are constitutional. Women’s Med. Ctr. of Providence, Inc. v. Roberts, 530 F. Supp. 1136 (D.R.I. 1982).


Mandatory Delays

No state measure.

Insurance Coverage for Abortion

Prohibits Abortion Coverage for Public Employees

Does Rhode Island expressly prohibit insurance plans for public employees from covering abortion services?

Yes.  Rhode Island has a partially unconstitutional and unenforceable law which provides that the state may not include abortion coverage in any employee health-insurance contract, plan, or policy, with exceptions only to save a woman’s life or if the pregnancy is the result of rape or incest.  Nothing in the law prohibits the purchase of abortion coverage through an optional rider for which an additional premium is paid.  However, insurers are not required to offer such riders and there is no evidence that such separate policies exist. (Even if they did exist, offering women the "option" to pay for separate abortion coverage is a false promise because no one plans for an unplanned pregnancy.) R.I. Gen. Laws Ann. § 36-12-2.1 (Enacted 1981, Amended 2019).

A court held that §36-12-2.1 is unconstitutional and unenforceable as applied to municipal employees. Nat’l Educ. Ass’n of R.I. v. Garrahy, 598 F. Supp. 1374 (D.R.I. 1984), aff’d, 779 F.2d 790 (1st Cir. 1986).


Prohibits Abortion Coverage in the Insurance Exchange

Does Rhode Island prohibit plans in its state exchange from covering abortion services? No.  However, Rhode Island does require insurance companies participating in the state exchange to offer at least one plan in each "metal" (e.g., bronze, silver, etc…) that excludes abortion coverage, with exceptions to save a woman’s life, or if the pregnancy is the result of rape or incest. (If non-religious small businesses select coverage that excludes abortion, their employees may choose a different plan that includes abortion coverage but then must pay the difference in cost.) 2015 R.I. Pub. Laws 5900.


Abortion Coverage for Low-Income People

Restricts Low-Income Women’s Access to Abortion

Rhode Island prohibits public funding of abortion for women eligible for state medical assistance for general health care unless the procedure is necessary to preserve the woman’s life or the pregnancy is the result of rape or incest.  R.I. Dep’t of Human Servs. Code of Rules, Medical Assistance, §0300.01 C(D)(1)(a) (Rev. June 2014); Rhode Island Dept. of Health & Human Services, Service Requiring Adherence to Federal Guidelines.

Rhode Island’s constitution has an invalid and unenforceable provision banning the use of public funds for abortion.  R.I. Const. art. I, § 2 (Enacted 1986).  This provision is in conflict with federal law.  Participating state medical assistance programs must meet the federal requirements for abortion coverage.  Federal law currently requires states participating in the Medicaid program to fund abortion in cases of life endangerment, rape, or incest.


Young People & Abortion

Parental Consent

Rhode Island law restricts young women’s access to abortion.

Is the law enforceable?  Yes.

Who is considered a minor?  A young woman under the age of 18 who is not married or emancipated.

What is required – parental consent or parental notice?  Consent.

Who must provide consent?  One parent.

Are there other trusted adults who may provide consent instead?  No.

What is the process for obtaining consent?  A young woman may not obtain an abortion unless one parent consents.

May the parental mandate be waived if a young woman is a victim of rape or incest?  No.

May the parental mandate be waived if a young woman is a victim of child abuse?  No.

May the parental mandate be waived if a young woman’s health is threatened?  Yes, in the case of "an emergency requiring immediate action."

May the parental mandate be waived under any other circumstances?  Yes, the young woman may try to obtain permission from a judge.

If a young woman must obtain permission from a judge, what is the process?  She must secure a court order stating either that she is mature and capable of informed consent or that an abortion is in her best interests.

Are there other significant requirements under the law?  No.

Has a court considered the constitutionality of this law?  No.


Family-Planning Policies

Insurance Coverage & Contraception

Supports Insurance Coverage of Contraception

Rhode Island law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception.

What is required?  If a health-insurance plan provides coverage for prescription medication, it must provide coverage for Food and Drug Administration-approved prescription contraception.

To which insurance plans does the law apply?  Individual or group health-insurance contracts, plans, or policies issued or renewed in the state, except certain limited benefit policies, that provide coverage for prescription medication.

Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage?  Yes.

To whom does the refusal clause apply?  Religious employers for whom prescription contraception is contrary to their bona fide religious tenets.

What does the refusal clause allow?  An insurer may issue a religious employer a health insurance contract, plan, or policy that excludes coverage for contraception.

Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women?  No.  The law appropriately defines the term "religious employer" as a tax-exempt church or association of churches or an elementary or secondary school controlled, operated, or principally supported by a church or an association of churches.  This definition is appropriately limited in scope, applying to religious entities but not broad-based entities that operate in the public sphere.

Does the law require the refusing entity to notify the persons affected?  Yes.  An employer exercising a refusal clause must provide written notice to prospective enrollees listing the contraceptive health-care services the employer refuses to cover.

Are there circumstances under which a refusal clause may not be exercised?  No.

Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause?  No.

R.I. Gen. Laws §§ 27-18-57, -19-48, -20-43, -41-59 (Enacted 2000).


Improves Insurance Coverage of Contraception

Rhode Island law requires health-insurance plans to cover dispensing of a 12-month supply of prescription contraceptives.

R.I. Gen. Laws §§ 27-18-57, -18-84, -19-48, -19-76, -20-43, -20-72, -41-59, -41-89 (Enacted 2018).


Contraception Coverage for Low-Income People

Supports Low-Income Women’s Access to Contraception

Rhode Island provides increased access to reproductive-health-care services through a Section 1115 waiver.  As part of this waiver, the state is allowed to cover family-planning services under its Extended Family Planning (EFP) program component of the waiver for 24 months for women with incomes at or below 250 percent of the federal poverty level who would lose Medicaid eligibility 60 days postpartum.  Additionally, enrollees must be (1) U.S. citizens or persons who meet the state’s defined immigration requirements and (2) Rhode Island residents.

Beneficiaries of family-planning coverage available through the waiver are not required to pay premiums, but must pay co-payments for covered services.

The waiver is set to expire Dec. 31, 2018.  

Rhode Island Comprehensive Demonstration, Project No. 11-W-00242/1, at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf.


Emergency Contraception

No state measure.

Other Important Issues

Clinic Protections

No state measure.

Refusals & Guarantees

Refusals of Medical Care

ABORTION REFUSAL CLAUSE

Rhode Island allows certain individuals to refuse to provide abortion services.

To whom does the refusal clause apply? Physicians or other persons associated with, employed by, or on the staff of a health-care facility.

What does the refusal clause allow? Allows physicians or other persons associated with, employed by, or on the staff of a health-care facility, who object in writing on moral or religious grounds to a scheduled abortion, to refuse to participate in medical procedures that result in an abortion. The refusal to participate may not be a basis for civil liability, disciplinary action, or recriminatory action.

No physician or other licensed health-care practitioner acting within the scope of his or her practice may be compelled to provide, and no person shall be compelled to assist in, abortion services.

Must the refusal be in writing? Yes.

Does the law require the refusing entity to notify the persons affected? No.

Are there circumstances under which a refusal clause may not be exercised? No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services? No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.

R.I. Gen. Laws Ann. § 23-17-11 (Enacted 1978; Last Amended 1979).

INSURANCE COVERAGE FOR CONTRACEPTION REFUSAL CLAUSE

Although Rhode Island law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception, certain employers may require that their plans exclude coverage for contraception.

To whom does the refusal clause apply? Religious employers for whom prescription contraceptive methods are contrary to their bona fide religious tenets.

What does the refusal clause allow? An insurer may issue a religious employer a health-insurance contract, plan, or policy that excludes coverage for contraception.

Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women? Yes. The law defines the term "religious employer" as a "church or a qualified church-controlled organization" as defined by federal law. This exemption allows a broad range of organizations engaged in secular activities, some of which may receive government funding, to deny women necessary services based on religious doctrine.

Does the law require the refusing entity to notify the persons affected? Yes. An employer exercising a refusal clause must provide written notice to prospective enrollees listing the contraceptive health-care services the employer refuses to cover.

Are there circumstances under which a refusal clause may not be exercised? No.

Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause? No.

R.I. Gen. Laws §§ 27-18-57, -19-48, -20-43, -41-59 (Enacted 2000; Last Amended 2002).

STERILIZATION REFUSAL CLAUSE

Rhode Island allows certain individuals to refuse to provide or participate in sterilization services.

To whom does the refusal clause apply? Physicians or other persons associated with, employed by, or on the staff of a health-care facility.

What does the refusal clause allow? Allows physicians or other persons associated with, employed by, or on the staff of a health-care facility, who object in writing on moral or religious grounds to a scheduled sterilization, to refuse to participate in medical procedures that result in a sterilization. The refusal to participate may not be a basis for civil liability, disciplinary action, or recriminatory action.

Must the refusal be in writing? Yes.

Does the law require the refusing entity to notify the persons affected? No.

Are there circumstances under which a refusal clause may not be exercised? No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services? No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.

R.I. Gen. Laws Ann. § 23-17-11 (Enacted 1978; Last Amended 1979).


Counseling & Referral Bans

No state measure.

Everyone should be able to decide if, when, how, and with whom they start or grow a family.

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