This report was written by Julia Rock and Andrew Perez.

Rhode Island Gov. Gina Raimondo has presided over one of the deadliest COVID outbreaks in the country — and new documents obtained by The Daily Poster detail how she helped nursing home lobbyists shield health care companies from coronavirus-related lawsuits.

Now, Raimondo — a former Wall Street executive — is reportedly being considered for the nation’s top health care policy job in the incoming Biden administration.

Politico reported last week that Raimondo, who made her name slashing state workers’ pensions, is one of the finalists to lead the U.S. Department of Health and Human Services under President-elect Joe Biden. Raimondo was also previously considered for Treasury Secretary, according to the American Prospect.

As governor, Raimondo has slammed proposals to expand Medicare to cover everyone. Amid the pandemic in August, her administration approved health insurance companies’ steep premium increases that were criticized by the state’s Democratic attorney general as “unnecessary and ill-advised.” Health insurers have been raking in record profits, with fewer people seeking care because of the pandemic.

Raimondo has also pushed for Medicaid cuts that nursing home workers warned would result in unsafe staffing levels — and in April, she issued an executive order sought by health care industry lobbyists that shielded nursing homes from lawsuits when their business decisions injure or kill people. The order was later expanded to shield nursing homes, hospitals, and other health care providers.

While the Biden transition is reportedly considering Raimondo for HHS Secretary, residents and workers in Rhode Island’s nursing homes have faced deadly consequences. Documents obtained by The Daily Poster show that Raimondo quickly responded to lobbyists’ demands for an executive order granting them legal immunity during the pandemic.

“What immunity has done is allow nursing homes to act unreasonably without accountability,” one personal injury lawyer told the Providence Journal last month.

Rhode Island currently has one of the highest coronavirus death rates by population in the country, according to data from the Centers for Disease Control and Prevention (CDC). More than 70 percent of COVID-19 deaths in the state have been linked to long-term care facilities — only two other states have seen similar nursing home death rates, according to the Kaiser Family Foundation.

The state’s hospitals are completely full. On Monday, patients were admitted to field hospitals for the first time in Rhode Island during the pandemic.

On April 9, top officials from Rhode Island’s nursing home lobbying groups sent a letter to Raimondo’s office requesting she give nursing home facilities immunity from civil liability if their residents faced injury or death from COVID. The Daily Poster obtained a copy of the letter through a public records request.

The letter — from the Rhode Island Health Care Association, the Rhode Island Assisted Living Association and LeadingAge RI — noted that nursing home facilities did not have enough personal protective equipment (PPE) and were experiencing staffing shortages due to “worker call-outs, quarantines and fear.”

The organizations requested that the governor issue an executive order making nursing home facilities and workers "immune from civil liability for any injury or death alleged to have been sustained... in the course of providing medical or other health and personal care services in support of the state of Rhode Island's response to the COVID-19 outbreak.”

One day later, the governor’s office issued an executive order granting the lobbyists what they had asked for: Facilities including hospitals and nursing homes were classified as emergency management facilities and granted immunity from civil liability, except in cases of gross negligence or willful misconduct.

A subsequent order reauthorizing the provision said the immunity provision applied to “health care entities, health care professionals and health care workers” at hospitals, nursing homes, and long-term care facilities.

“Reinventing Medicaid”

In 2015, newly-elected Governor Raimondo announced her plans to “reinvent Medicaid,” a proposal that would result in cuts to Medicaid in each of her proposed budgets for the next five years.

At the time, nursing home administrators warned what the cuts would mean for their facilities — staffing cuts. One said in a subcommittee hearing: “It’s keeping me up at night. It’s making me very nervous. We have a lot of sick, elderly frail people in these nursing homes and when you look at what you have to do to provide for them and for the people that care for them… Probably 90 percent of our employees are mothers, single mothers. Women.”

Another administrator said, “Have we lost sight of the individuals we have an obligation to protect and care for? These individuals’ lives are literally hanging in the balance.″

Raimondo’s plan also involved privatizing management of Medicaid in the state, outsourcing management to private insurers. By 2018, over 60 percent of the state’s Medicaid budget went to private health insurers. That year, hospital administrators called Raimondo’s round of cuts to Medicaid “devastating.”

The governor’s proposed budget for 2020, introduced before the pandemic broke out in the U.S., included nearly $60 million in Medicaid cuts.

Photo credit: Fortune Most Powerful Women Summit

This newsletter relies on readers pitching in to support it. If you like what you just read and want to help expand this kind of journalism, consider becoming a paid subscriber by clicking this link.

Subscribe now