PROVIDENCE — Lt. Gov. Elizabeth Roberts is set to release a legislative package this afternoon aimed at increasing access to health care for the 13 percent of Rhode Islanders who don’t have it, in part by requiring individuals and employers to purchase health insurance or face penalties.

Under her plan, businesses with more than 10 employees that don’t offer health insurance would be compelled to pay a $1,000-a-year assessment per employee, starting in July 2009. Individuals making at least $40,840 and families making $82,600 would be obligated to buy at least minimal insurance, or forfeit a tax exemption. The plan would also allow all dependent children up to age 25 to stay on their parents’ insurance.

A sizable percentage of the uninsured — at least 10 percent Roberts reports — make more than the required income levels, yet decide not to purchase insurance, often because they are young and healthy. Requiring them to get coverage would eliminate a big part of the problem without spending any new money in tight budget times, the lieutenant governor says.

Known as the “Healthy Rhode Island Reform Act of 2008” the proposal is patterned after a new Massachusetts law that requires all residents to have health insurance.

Roberts says the difference is that the Rhode Island plan takes its time and doesn’t guarantee any state dollars just yet. It may take several years to roll out each piece of her proposal, but she hopes that announcing it as a package will start a long-term conversation about health-care reform in the state.

“It’s not a simple process. There will need to be a lot of public dialogue and debate,” Roberts said. “This bill doesn’t say a year from now every Rhode Islander will have health insurance.”

Since its unveiling last spring, the Massachusetts plan has encountered unexpected cost overruns as the state tries to help foot the insurance bill for those who can’t afford it and don’t qualify for subsidy programs.

“What you are experiencing in Massachusetts now is a struggle to realize how they are going to pay for that public investment. I think we should be realistic about that up front and these bills lay out a process to have a very serious discussion about that,” she said.

So while everyone in Rhode Island will be required to have health insurance, those who cannot afford it and do not qualify for state subsidies might see a reprieve from the requirement for several years until the state figures out how to pay for their care. Roberts has not yet proposed an exact financing mechanism, but has suggested several possibilities including using state dollars or money collected through the assessments.

Helping to coordinate the various strands, will be a board known as the HealthHub. Similar to the Massachusetts “connector,” and run out of the state health commissioner’s office, it would help enforce the mandates and work to offer more affordable insurance products that individuals and small businesses could purchase.

Presumably, the state’s two health insurers, Blue Cross & Blue Shield of Rhode Island and United HealthCare of New England, would offer a variety of health plans through the Hub from bare-bones products to more comprehensive coverage. The plan would also allow insurers licensed in Massachusetts and Connecticut to offer coverage in Rhode Island without securing local licenses. Roberts believes that too could increase competition and drive prices down.

(Two of those insurers, Harvard Pilgrim Health Care and Tufts Health Plan, left Rhode Island almost a decade ago. Harvard’s financial operation here collapsed and Tufts departed not long after. But Roberts says at least one out-of-state company has expressed interest in returning.)

The Greater Providence Chamber of Commerce says it plans to poll its members in the business community to gauge support for the employer insurance requirement.

Part two of the lieutenant governor’s legislative package would tackle the preventative side of health care via a long list of initiatives to include the following:

•Create a Health Department database that tracks specific services such as the number of mammograms performed in this state each year to get a better idea of where health-care dollars go.

•Standardize management of chronic conditions such as diabetes with the goal of getting all doctors to follow the same protocol for care, possibly though incentives.

•Require insurers to reimburse doctors and nurses for time spent educating patients about their conditions.

•Mandate the designation of a primary-care physician.

Each part of the overall plan would require legislative approval. House and Senate leaders are expected to be on hand when Roberts releases her proposal today. House Majority Leader Gordon D. Fox will introduce parts of the legislation.

“I told [the lieutenant governor] I would be proud to sponsor one of the bills in her legislation package to get the discussion started in the General Assembly,” Fox said through a spokesman yesterday. “Even though we have a budget crisis, it does not mean that we can’t begin planning for the future, and her initiatives may set a foundation for us to follow.”

Senate leaders refused to comment until they read the exact language in the legislation.

Carcieri spokesman Jeff Neal also declined comment saying the governor had not seen the proposal.

The lieutenant governor’s policy director, Jennifer Wood, said that Roberts’office expects it will take time to garner support for the entire package, which is why it is critical to lay out ideas.

“This is about starting the most substantive dialogue we could in the General Assembly and moving as many pieces of this puzzle forward,” Wood said.

cneedham@projo.com