1. health and fitness

The Economic Impact of
Expanding Medicaid
BY
Liam C. Malloy, Ph.D.
University of Rhode Island
Shanna Pearson-Merkowitz, Ph.D.
University of Rhode Island
2015
REGIONAL
COMPETITIVENESS
2015
REGIONAL COMPETITIVENESS
WILL EXPANDING MEDICAID HELP THE ECONOMY?
50 Park Row West, Suite 100
Providence, RI 02903
www.collaborativeri.org
Amber Caulkins
Program Director
[email protected]
401.588.1792
The College & University Research Collaborative (the Collaborative)
is a statewide public/private partnership of Rhode Island’s 11 colleges
and universities that connects public policy and academic research. The
Collaborative’s mission is to increase the use of non-partisan academic
research in policy development and to provide an evidence-based
foundation for government decision-making. The Collaborative turns
research into action by sharing research with policymakers, community
leaders, partner organizations, and the citizens of Rhode Island.
CURRENT Research Projects
WORKFORCE
The Economic Benefits of a Flexible Workplace
by Barbara Silver, Ph.D., University of Rhode Island
The Knowledge, Skills, and Abilities Needed for Growing Occupations in Rhode Island
by Matthew Bodah, Ph.D., University of Rhode Island
Preparing Rhode Island’s Workforce for the Jobs of the Future
by Elzotbek Rustambekov, Ph.D., Bryant University
Rhode Island Unemployment: Is There a Labor Market Mismatch?
by Neil Mehrotra, Ph.D., Brown University
Liam C. Malloy, Ph.D., is an Assistant Professor in the Department
of Economics at the University of
Rhode Island. He earned his Ph.D.
in Economics from the University of
Maryland, focusing on macroeconomics and political economy. His
research focuses on the causes and
consequences of income distribution, mainly in the United States. He
focuses on behavioral and political
economy explanations of the income
distribution. His work has appeared
in Education Economics, The American Prospect, and HBR Online.
Shanna Pearson-Merkowitz, Ph.D.,
is an Associate Professor of Political
Science at the University of Rhode
Island. She received her Ph.D. in
2009 from the University of Maryland,
College Park. Her research focuses
on public policy, inequality, and political geography. Professor PearsonMerkowitz’s research has appeared
in some of the top political science
journals including the Journal of Politics and the American Journal of Political Science.
INFRASTRUCTURE
Improving Infrastructure through Public Private Partnerships
by Amine Ghanem, Ph.D., Roger Williams University
Millennials on the Move: Attracting Young Workers through Better Transportation
by Jonathan Harris, M.I.D., Johnson & Wales University
The Road to Better Bridges: Strategies for Maintaining Infrastructure
by Nicole Martino, Ph.D., Roger Williams University
REGIONAL COMPETITIVENESS
Choosing a Health Exchange for Rhode Island
by Jessica Mulligan, Ph.D., Providence College
The Economic Impact of Expanding Medicaid
by Liam Malloy, Ph.D., University of Rhode Island; Shanna Pearson-Merkowitz, Ph.D., University of
Rhode Island
Ensuring Paid Family Leave Pays Off
by Shanna Pearson-Merkowitz, Ph.D., University of Rhode Island
Rachel-Lyn Longo, Student Researcher, University of Rhode Island
Strategies for a Competitive Rhode Island
by Suchandra Basu, Ph.D., Rhode Island College; Ramesh Mohan, Ph.D., Bryant University; Joseph
Roberts, Ph.D., Roger Williams University
MANUFACTURING
Rhode Island’s Maker-Related Assets
by Dawn Edmondson, M.S., New England Institute of Technology; Susan Gorelick, Ph.D., New England
Institute of Technology; Beth Mosher, MFA, Rhode Island School of Design
WILL EXPANDING MEDICAID HELP THE ECONOMY?
The Economic Impact of
Expanding Medicaid
Liam C. Malloy, Ph.D., University of Rhode Island
Shanna Pearson-Merkowitz, Ph.D., University of Rhode Island
On March 23, 2010, President Obama signed the Patient Protection
and Affordable Care Act (ACA) designed to increase health
insurance coverage among the U.S. population. A key component
of the law was an expansion of Medicaid to cover up to 17 million
more low-income individuals.(a) After a series of legal challenges,
in 2012 the Supreme Court upheld many parts of the Affordable
Care Act but ruled that states could not be required to expand
(a) Medicaid is the
government’s health
insurance program for
low-income individuals;
it is jointly funded and
administered by the federal
and state governments.
Medicare, on the other
hand, is the federal health
insurance program for
individuals over age 65 and
people with disabilities.
(b) After the Supreme Court
decision, the Congressional
Budget Office revised its
estimates and predicted that
13 million people, rather
than 17 million, would gain
coverage under Medicaid and
CHIP by 2018.1
Medicaid coverage.(b) Since then, just over half of states have
chosen to expand Medicaid, while the remainder have not.2 The
decision whether or not to expand Medicaid has had a substantial
impact on access to health care coverage, and states like
Rhode Island that chose to expand have had significantly higher
increases3 in the percentage of their population covered.
Fig. 1 PERCENTAGE CHANGE IN Medicaid enrollment
since expansion
Adopted Medicaid expansion
Not adopting Medicaid expansion
Medicaid expansion under consideration
80%
60%
40%
20%
0%
AL AK AZ AR CA CO CT DE DC FL GA HI
ID
IL
IN
IA KS KY LA ME
MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA
RI SC SD TN TX UT VT VA WA WV WI WY
Source: Kaiser Family Foundation, State Health Facts database 2,3
The Collaborative | March 2015
2
The Economic Impact of Expanding Medicaid
Since the implementation of the Affordable Care
Act,(c) enrollment in Medicaid and the Children’s
Health Insurance Program (CHIP) in Rhode Island increased 37%, from 191,000 to 262,000.3
Rhode Island effectively reduced its total uninsured population to an estimated 9.3% by mid2014, from 13.3% prior to the implementation
of the ACA (the current national figure is 13.4%
and was 17.3% before the ACA).4 Overall, uninsured rates still vary widely from state to state,
from 24.0% in Texas to 4.9% in Massachusetts.4
If we look simply at the number of people covered, Rhode Island’s decision to expand Medicaid
was a success. But the arguments for the expansion of health insurance made by the Obama
administration were not just moral – they were
also economic. The Council of Economic Advisors argued that the lack of health care coverage
among many Americans has a significant negative effect on national economic prosperity.5 On
the other side, critics and political leaders in states
that rejected the expansion worried that enlarging
Medicaid would hurt state economies and strain
state budgets.6
Fig. 2 and 3 Uninsured Rates prior to and after
medicaid expansion
17.3%
U.S.
13.4%
Percent uninsured
2013
2014
Percentage of Population Uninsured
(c) The ACA expanded
Medicaid eligibility from
people living at or below the
federal poverty line ($11,670 a
year for one person, $23,850
for a family of 4) to people
earning up to 138% of the
poverty line ($16,105 a year
for one person, $32,913 for a
family of 4). Funding for the
expansion is provided by the
federal government.
Source: Gallup, Gallup-Healthways Well-Being Index survey 4
Did Rhode Island make the right choice by expanding Medicaid? What
will the impact of that decision be on the state’s economy? To answer this
question, we analyze how health insurance coverage rates and health
care spending levels affected economic growth in 48 states over 23 years.
Our research indicates that the expansion of health insurance coverage
can help Rhode Island’s economy, but only if the state controls costs.
3
The Collaborative | March 2015
The Economic Impact of Expanding Medicaid
insurance has been shown to decrease the onset
of avoidable illnesses, increase access to care for
treatable illnesses, and decrease the likelihood
that relatively minor illnesses become severe.9
Health care coverage, however, is not without its
costs, and these costs must be balanced against
the economic gains that come from better health.
The Relationship Between Health
Coverage and Economic Growth
Despite the lively debate in the popular press over
the potential economic consequences of expanding health care coverage, few studies have directly
investigated the effect of universal or near-universal health insurance on employment and economic growth. Instead, the academic literature to
date largely relies on the assumption that because
greater access to health insurance improves health
and better health leads to economic growth,
health insurance coverage should have a positive
economic effect. This, however, does not account
for the potential negative effects of health care
costs.
(d) Reducing the prevalence
of particular health
conditions has been shown
to increase personal earnings
by 15 to 20%, while poor
health has been identified as
a primary reason people leave
the workforce early and file
for social welfare programs,
particularly Disability (SSI).6
What is less clear from existing research is the
overall effect of health care spending on economic
growth. While some literature suggests that it can
act as an economic stimulus by increasing both
wages and the number of jobs in the health care
sector,10 escalating health care costs can also be a
serious drag on economic growth.(e) Health insurance premiums, for instance, have risen by 69%
since 2004,11 and studies have documented that
premium increases meaningfully cut into wages
and raise the likelihood of being unemployed or
underemployed.12 For state governments, increasing health costs can result in higher taxes, more
borrowing, or cuts to other important programs
and services, including economic growth investments such as education and infrastructure.13 It is
also important to consider that health care spending is not necessarily associated with better health
outcomes: The United States spends far more per
person on health, yet has a lower life expectancy
than many other developed nations.(f)
The economic benefits of having a healthy population are clear: workers are more productive, less
likely to miss work due to illness or disability, and
less likely to leave the workforce due to illness or
death.(d) Several studies indicate that improved
health outcomes are “one of very few robust predictors of economic growth,”7 and research suggests that health improvements since the 1970s
added approximately $3.2 trillion per year to national wealth in the United States.8 The studies
are also clear that health insurance coverage can
help create a healthier population. Quality health
(e) While the Affordable Care
Act originally had provisions
included to help control the
increase in health spending
in the United States, these
items were cut in an attempt
to gain passage as people
became concerned about the
government making health
care decisions instead of
doctors.
(f) Life expectancy at birth
in the United States is
79, placing the U.S. 35th
worldwide. 83 is the life
expectancy in most European
Union countries.14
Life Expectancy (years)
Fig. 4 Health Care Spending and Life Expectancy Around The World, 2012
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
Health Expenditure as a % of GDP
Source: World Bank, World Development Indicators database14
The Collaborative | March 2015
4
The Economic Impact of Expanding Medicaid
our research ON the Economic
Findings
Impact of Health Coverage and
(g) Private, employer-provided
insurance could be linked
to economic growth simply
because it is a proxy for
employment. Public health
insurance programs, on
the other hand, often cover
low-wage workers and the
unemployed.
(h) There are a number of
potential reasons why public
coverage impacts economic
growth but private coverage
does not, many of which
have to do with the different
populations covered by the
two. Almost everyone with
private coverage, for example,
already has a job, so health
coverage will not increase
their labor supply.
Health Spending
Economic Growth & Health Insurance Coverage
While existing research offers good reason to believe that expanding health care coverage can help
the economy by making workers healthier and
therefore more productive, it also suggests that, to
the extent that enlarging coverage increases government spending, the net effect on the economy
may be negative. Our research takes into account
both of these factors – expanded coverage and increased spending – by looking directly at the connection between health care coverage, health care
spending, and economic growth.
Our analysis indicates that enrollment by working-age adults in government-sponsored health
insurance programs – including Medicaid, Medicare, and military health plans – all increase economic growth. Our estimates suggest that a one
percentage point increase in public coverage of
the working-age population increases annual real
GDP growth by 0.08 percentage points and increases employment growth by the same 0.08
percentage points. However, our analysis indicates
that there is no significant relationship between
private coverage for the working-age population
and economic growth.(h)
Using data from the Centers for Medicare and
Medicaid Services and the U.S. Census, we analyze how health insurance coverage and health
care spending affected economic growth (in terms
of GDP and total employment) in the lower 48
states from 1988 to 2010.15 We compare rates of
private and public coverage and analyze coverage
by age group, with a particular focus on the working-age population of 18 to 65 year olds.(g) We
examine health care spending both per capita and
as a percentage of state GDP, and we break it out
into private spending and government spending
on Medicare, Medicaid, and military health care
(for both active duty servicemembers and veterans). We also include a number of control variables in our analysis to ensure our findings are not
driven by unobserved factors.
To understand the significance of these findings,
consider Medicaid, the public health insurance
program over which states have the most control
(because it is jointly funded and administered by
the federal and state governments). In 2013, only
13% of working age adults in Rhode Island were
covered by Medicaid, close to the national average
of 12%.16 However, enrollment surged in the first
year of the Medicaid expansion, with total enrollees (including children and the elderly) increasing
37% by November 2014.3 Although the data do
not indicate what share of the new enrollees are
working-age adults, a conservative estimate suggests that this increase in Medicaid enrollment
included a five percentage point increase in public
Our analysis indicates that enrollment by working-age adults in
government-sponsored health insurance programs – including Medicaid,
Medicare, and military health plans – all increase economic growth.
5
The Collaborative | March 2015
The Economic Impact of Expanding Medicaid
coverage of the working age population, bringing
the rate to 18%. The results of our analysis suggest that this could lead to a 0.4 percentage point
increase in state per capita GDP growth and employment growth rates.(i)
Fig. 5 Medicaid Spending Per Enrollee, 2011
CT
MA
RI
Economic Growth & Health Care Spending
Our analysis indicates that the more individuals
and businesses spend per person on health care,
the less economic growth states experience (the
job growth rate is not affected). A one percent
increase in private health care spending is associated with a 0.05 percentage point decrease in a
state’s GDP growth rate. This is probably due to
the “crowding-out” effect of health care spending,
in which money that businesses spend on health
care is money they don’t use to increase wages,
hire new employees, or invest in new product development.12 Likewise, the more individuals pay
in health care costs, the less likely they are to save
or to spend that money on goods, services, and investments such as higher education and the more
likely they are to go into debt or file for bankruptcy.17
In contrast to private spending, increased government spending on health care does not appear to
affect economic (GDP) growth. However, higher
public spending, especially Medicaid spending
per enrollee, is associated with slower job growth.
This may be due to the fact that Medicaid spending and spending on job growth investments such
as education and infrastructure are typically inversely related. For example, one study found that
each additional dollar that states spend on Medicaid results in a 6 to 7 cent cut in higher education
appropriations.13
Our analysis indicates that a one percent increase in Medicaid spending per enrollee reduces
USA
Source: Kaiser Family Foundation, State Health Facts database16
a state’s employment growth rate by 0.008 percentage points per year. In 2011, the last year
for which national data are available, Rhode Island spent $9,247 per enrollee on Medicaid, the
second-highest rate in the country.18 If the state
could reduce Medicaid spending to the 2011 national average of approximately $5,790 per enrollee – about a 37% decrease – the employment
growth rate could be increased by as much as 0.29
percentage points.(j) This represents a significant
potential impact given that Rhode Island’s employment growth rate averaged around 0.4% annually over the past decade.
Controlling Health Care Costs
Reducing health care costs while maintaining
quality care – and thus reaping the economic
benefits of expanded coverage – is a complicated
endeavor.(k) One option is managed care programs, in which health care is coordinated, typically through a patient’s primary care physician, to
manage usage, quality, and costs. While evidence
on the impact of managed care is mixed, research
suggests that enrolling high-cost populations in
these programs has the most potential to save
(i) From 2000 to 2013, per
capita GDP growth in Rhode
Island averaged less than
1.3% and employment growth
averaged less than 0.4%
according to the Bureau of
Economic Analysis. Thus a
0.4 percentage point increase
in the growth rates would be
quite large.
(j) Like Medicaid coverage
rates, spending per enrollee
varies significantly from state
to state, from a low of $3,728
in Nevada to a high of $9,474
in Alaska (as of 2011).18
(k) Restricting care is one
obvious way to reduce
costs, but doing so would be
counterproductive because
the economic benefits of
expanded insurance coverage
come from having healthier,
more productive workers.
The Collaborative | March 2015
6
The Economic Impact of Expanding Medicaid
(l) 79% of Medicaid enrollees
in Rhode Island cost
Medicaid less than $5,000
a year. The average annual
expenditure for this group
is $992 per person annually,
meaning that the top 7% of
Medicaid users cost almost
seventy times as much
per person as those in the
bottom 79%.20
money.19 Rhode Island already has a managed care
program that includes almost three-quarters of its
Medicaid population. However, over half of the
state’s Medicaid spending is on the 23% of people
not covered by the program.20
In fact, Medicaid spending varies widely from
person to person and is extremely concentrated
among certain groups. In Rhode Island, approximately 7% of enrollees account for about 66%
of Medicaid expenditures, costing an average of
$66,396 per person in 2013.(l) Complex care management is a promising approach that focuses on
controlling costs for these kinds of high-expenditure populations. In a complex care management
program, a team of specialized social workers,
nurses, and care managers identifies high-cost
patients and determines what is driving their use
of medical services. The team then works directly
with these patients to manage and coordinate
their care and reduce the incidence of hospitalization and emergency room visits.
While complex care management takes concerted
effort, recent research suggests that the costs may
be worth it. One study of an initiative in St. Louis
that included long-term, in-person oversight of
care found that the program “reduced hospitalizations by 12% and monthly Medicare spending
by $217 per enrollee – more than offsetting the
program’s monthly $151 care management fee.”21
Camden, New Jersey’s “Camden Coalition” has
served as a model of this type of cost control, as
have programs at Massachusetts General Hospital in Boston that are designed to meet the needs
of high-expenditure cases. Recent evidence from
these programs suggests that emergency room
visits by high-expenditure individuals dropped, as
did overall costs for these patients.22
Fig.6 Distribution of Rhode Island Medicaid
Spending Among Enrollees, 2013
Share of Users
Annual Claims
Expenditures per User
Source: Rhode Island Executive Office of Health and Human Services18
7
The Collaborative | March 2015
Share of Expenditures
The Economic Impact of Expanding Medicaid
Is Rhode Island on the right track?
Our research suggests that Rhode Island is on the right path in joining
27 other states to expand Medicaid coverage through the ACA. Increased
health insurance coverage of the working-age population through
government programs like Medicaid is associated with stronger GDP
and employment growth. That said, Rhode Island currently spends more
on Medicaid per enrollee than most states, and higher spending can drag
down job growth. Decreasing the amount spent per person on health
care would provide an opportunity for Rhode Island to fully harness the
economic benefits of expanding health insurance coverage and address
the state’s high unemployment rate.
Massachusetts, which began health insurance reform in 2007,
well before the rest of the country, can serve as a model. They
decreased their uninsured rate from 10% in 2004 to 4% by
2012, largely by expanding Medicaid eligibility and increasing
Medicaid enrollment from 17% in 2004 to 26% in 2010. Over
that same time period, however, they reduced their Medicaid
spending from $9,600 (similar to Rhode Island’s 2011 level)
to $7,500 per enrollee.23 Rhode Island has begun to reduce its
costs per Medicaid enrollee, at a rate of about 1.5% per year
from 2009 to 2013.20 If the state can continue to make strides in
expanding coverage and cutting costs, it can both improve the
health of its citizens and grow its economy.
The Collaborative | March 2015
8
WILL EXPANDING MEDICAID HELP THE ECONOMY?
ENDNOTES
1.
Congressional Budget Office (2012) “Updated Estimates for the Insurance Coverage Provisions of the Affordable Care
Act,” and (2014) “Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act,”
Washington, DC.
2.
Kaiser Family Foundation (2015) Status of State Action on the Medicaid Expansion Decision [data files].
3.
Kaiser Family Foundation (2014) Total Monthly Medicaid and CHIP Enrollment [data files].
4.
Dan Witters (2014) “Arkansas, Kentucky Report Sharpest Drops in Uninsured Rate,” Gallup, August 5.
5.
Council of Economic Advisers ( 2009) The Economic Case for Health Care Reform, Washington, D.C.: Executive Office of
the President.
6.
Jack Hadley (2003) “Sicker and Poorer—The Consequences of Being Uninsured: A Review of the Research on the
Relationship between Health Insurance, Medical Care Use, Health, Work, and Income,” Medical Care Research &
Review, 60(2): 3S-75S. Sandra L. Decker, Jalpa A. Doshi, Amy E. Knaup, and Daniel Polsky (2012) “Health Service Use
among the Previously Uninsured: Is Subsidized Health Insurance Enough?” Health Economics, 21(10): 1155–1168.
7.
Marc Suhrcke & Dieter Urban (2010) “Are cardiovascular diseases bad for economic growth?,” Health Economics, 19(12):
1478-1496.
8.
Kevin M. Murphy and Robert H. Topel (2006) “The Value of Health and Longevity,” Journal of Political Economy, 114(5):
871-904.
9.
Jill Bernstein, Deborah Chollet, and Stephanie Peterson (2010) “How Does Insurance Coverage Improve Health
Outcomes?” Mathematica Policy Research, Reforming Health Care Issue Brief, number 1.
10. Mark V. Pauly (2004) “Should We Be Worried About High Real Medical Spending Growth In The United States?” Health
Affairs, 22(3, supp.): W3-15.
11. Kaiser Family Foundation (2014) “2014 Employer Health Benefits Survey,” Menlo Park, CA.
12. Katherine Baicker and Amitabh Chandra (2005) “The Labor Market Effects of Rising Health Insurance Premiums,”
National Bureau of Economic Research, Working Paper, number 11160. Benjamin D. Sommers (2005) “Who Really Pays
for Health Insurance? The Incidence of Employer-Provided Health Insurance with Sticky Nominal Wages,” International
Journal of Health Care Finance and Economics, 5(1): 89-118.
13. Thomas J. Kane, Peter Orszag, David L. Gunter (2003) “State Fiscal Constraints and Higher Education Spending: The Role
of Medicaid and the Business Cycle,” Urban-Brookings Tax Policy Center, Discussion Paper, number 11. Neeraj Sood,
Arkadipta Ghosh, and J. Escarse (2007) “The Effect of Health Care Cost Growth on the US Economy,” Washington, D.C.:
Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services.
14. World Bank (2014) “Health Expenditure, total (% of GDP),” World Development Indicators [data files].
15. Our data include many different types of health care spending in order to verify the relationship between different
health care investments by the state and private entities and state economic growth. These include overall health
care spending; specific spending for Medicaid, Medicare, and military health care by the government; and health care
expenditures in the private market.
16. Kaiser Family Foundation (2013) Medicaid Coverage Rates for the Nonelderly by Age [data files].
17. David U. Himmelstein, Deborah Thorne, Elizabeth Warren, and Steffie Woolhandler (2009) “Medical Bankruptcy in the
United States, 2007: Results of a National Study,” The American Journal of Medicine, 122(8): 741–746. Ryan Jaslow (2012)
“One-third of young adults face medical bill troubles, debt,” CBS News, June 8.
18. Kaiser Family Foundation (2011) Medicaid Spending per Enrollee (Full or Partial Benefit) [data files].
19. Michael Sparer (2012) “Medicaid managed care: Costs, access, and quality of care,” Robert Wood Johnson Foundation,
Research Synthesis Report, number 23.
20. Rhode Island Executive Office of Health and Human Services (2014) “Rhode Island Annual Medicaid Expenditure
Report,” Providence, RI.
21. Deborah Peikes, Greg Peterson, Randall S. Brown, Sandy Graff, and John P. Lynch (2012) “How changes in Washington
University’s Medicare coordinated care demonstration pilot ultimately achieved savings,” Health Affairs, 31(6): 1216-1226.
22. Atul Gawande (2011) “The Hot Spotters,” New Yorker, January 24.
23. The Pew Charitable Trusts (2014) State Health Care Spending on Medicaid, 50 State Data [data files].
The Collaborative was developed in response to calls from the Governor’s office,
public officials, and community leaders to leverage the research capacity of the
state’s 11 colleges and universities and to provide non-partisan research for
informed economic policy decisions.
50 Park Row West, Suite 100
Providence, RI 02903
www.collaborativeri.org
Amber Caulkins
Program Director
[email protected]
401.588.1792
Following the Make It Happen RI economic development summit, the Rhode
Island Foundation committed funding for the creation of the Collaborative. As a
proactive community and philanthropic leader, the Foundation recognized the
Collaborative as an opportunity for public and private sectors to work together
to improve the quality of life for all Rhode Island residents. In FY 2013, the State
of Rhode Island matched the Foundation’s funding, viewing the Collaborative as
a cost-effective approach to leverage the talent and resources in the state for
the development of sustainable economic policy.
Rhode Island’s 11 colleges and universities agreed to partner with the
Collaborative, and the presidents from each institution formed the Leadership
Team. A Panel of Policy Leaders was appointed by the Governor’s office,
the Rhode Island House of Representatives, and the Rhode Island Senate
to represent both the executive branch and the legislative branch of state
government. This panel is responsible for coming to consensus on research
areas of importance to Rhode Island.
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The Association of Independent Colleges and Universities of Rhode Island is an alliance
representing the eight independent institutions of higher learning within the State of Rhode Island.
Designed to address common interests and concerns of independent colleges and universities
within the state, the Association serves as the collective and unified voice of its member
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For questions and more information about
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