By Awilda Reinoso Lopez, M.A and Morgan Leonard, MPA
A young mother walked into Clínica Esperanza’s walk-in clinic in Providence with a minor kitchen injury. She almost did not come at all.
Like thousands of uninsured patients in Rhode Island, she had been quietly managing other symptoms for years, too afraid of medical bills to seek care. She did not know how to navigate the healthcare system, and she had done the math enough times to know what a medical bill could mean for her family. Healthcare or rent. Healthcare or food. She had made her choice, over and over, until a minor injury gave her a reason to finally walk through our doors.
That visit likely saved her life.
Further evaluation revealed a growing tumor on her pituitary gland. Left untreated, it would have caused permanent blindness. With support from Clínica Esperanza’s team, she enrolled in coverage through HealthSource RI, the state’s Affordable Care Act marketplace for individuals who do not receive health insurance through their employer. She received the specialty care and navigation services she needed. Today, she is healthy, working, and raising her family with dignity and peace of mind.
Her story is not an outlier. It is a window into what daily life looks like for thousands of Latino families across Rhode Island, families navigating a healthcare system that too often feels inaccessible, even when coverage technically exists. And right now, the policies that made her story possible are under serious threat.
Federal cuts to Medicaid and the Affordable Care Act marketplace stand to strip health insurance from more than 53,000 Rhode Islanders, including refugees and asylees, more than doubling the state’s uninsured population. These cuts will not land evenly. They will place additional strain on communities already navigating significant barriers to care, and Latino families will absorb a disproportionate share of the damage.
This is not a prediction. We are already watching it happen.
When federal pandemic-era protections ended, the Medicaid “unwinding” process began in April 2023 and continued through the spring of 2024, triggering the loss of coverage for thousands of Rhode Islanders. Many lost their insurance not because they were ineligible, but because the system failed them. Renewal paperwork was complex. Notices arrived in languages they did not speak. Some families had no idea they needed to reenroll at all. For Latino families, the administrative burden of staying insured became yet another obstacle in a system that was not designed with them in mind.
At Clínica Esperanza, we felt the consequences immediately. Compared to 2019, before continuous Medicaid enrollment was implemented, we experienced a 52 percent increase in patients and a 55 percent increase in visit volume by 2024. More than 90 percent of new patients identified as Latino. Families who had lost coverage, or never had it, were turning to our clinic and to the broader healthcare safety net in growing numbers. In 2025 alone, patient volume climbed another 12%. If current trends hold, we anticipate being forced to turn away more than 3,000 Rhode Islanders by the end of 2026 simply because the need for care has outpaced our ability to provide it.
This surge is happening against a backdrop of deep, persistent inequity. Latino residents remain among the most likely racial and ethnic groups in the U.S. to be uninsured or underinsured, even after years of progress under the Affordable Care Act. Here in Rhode Island, according to the Rhode Island Department of Health, Hispanic adults are more likely to be uninsured than adults of any other race or ethnicity. Even when insured, many Latino families face high out-of-pocket costs, limited provider networks, language access challenges, and the relentless work of navigating systems that were not built with their communities in mind.
The consequences of that gap stretch far beyond a doctor’s office. When families delay preventive care, manageable conditions become serious ones, and serious ones become expensive emergencies. Parents miss work. Children fall behind in school. Chronic stress accumulates. The financial pressure of an untreated health condition can destabilize a family that was already living close to the edge. Healthcare inequity does not stay contained. It limits economic mobility, deepens educational disparities, and reinforces cycles of disadvantage that entire communities are left to absorb.
Two bills before the Rhode Island legislature address these issues directly, and both deserve passage.
The Rhode Island Individual Market Affordability Act of 2026 (House Bill 7466 / Senate Bill 2255) would restore enhanced advance premium tax credits that, until they expired at the end of 2025, helped more than 40,000 Rhode Islanders afford health coverage through HealthSource RI, including the mother whose story opens this piece. When those subsidies expired, average premiums on the Marketplace doubled in 2026. Without this bill, Rhode Island leaves $70 million in federal funding unclaimed, money that would otherwise go directly into Rhode Islanders’ pockets and back into our local healthcare system. By 2027, 13,000 more Rhode Island residents will be uninsured.
The Protect Our Healthcare Act of 2026 (House Bill 8137 / Senate Bill 2811) would provide critical funding to the safety net providers that serve those who fall through every other gap: hospitals, community health centers, and free clinics like Clínica Esperanza. We see every patient who walks through our doors, regardless of their ability to pay. We will keep doing that. But we cannot sustain it without resources. This bill would also create more affordable options for uninsured Rhode Islanders to access essential care, including prescription drugs, cancer screenings, imaging, medical equipment, and scheduled surgeries. Right now, uninsured patients often pay entirely out of pocket for these services, which means many delay care until something treatable has become a crisis, driving up costs for everyone.
Passing both bills is necessary. And beyond them, Rhode Island must invest in: more bilingual providers, stronger interpretation services, community-based preventive care, and mental health resources that reflect the people they serve. Families should not have to be fluent in bureaucracy to get a diagnosis.
The young mother who walked into our clinic with a kitchen injury is healthy today because someone helped her find coverage before it was too late. Thousands of Rhode Islanders are one lost notice, one unaffordable premium, one administrative barrier away from a very different outcome.
Our families should not have to choose between paying rent and seeing a doctor. They should not have to translate medical terminology in moments of crisis. They should not have to delay care until something that could have been caught becomes something catastrophic.
Rhode Island has a chance to get this right. These two bills are where that work starts. We are asking the legislature to pass them.
Awilda Reinoso Lopez, M.A., is the Senior Policy & Research Manager at the Latino Policy Institute, where she advances research and policy initiatives that improve outcomes for Latino communities across Rhode Island. She earned her Master of Arts in Urban Education Policy from Brown University and her Bachelor of Arts in Economics from Clark University.
Morgan Leonard, MPA, is the Executive Director of Clínica Esperanza/Hope Clinic, a free clinic located in Providence, RI that serves over 3,300 uninsured adults annually. She earned her Master of Public Administration with a concentration in Healthcare Management and Policy from Northeastern University.
The Latino Policy Institute (LPI) is a nonpartisan research and policy organization dedicated to advancing equity and opportunity for Latino communities in Rhode Island. LPI produces data-driven research, shapes state and local policy, and builds the power of Latino communities to advocate for themselves. LPI is a proud member of the Protect Our Healthcare Coalition. Learn more at thelatinopolicy.org.
