North Dakota Senate Passes Obamacare Medicaid Expansion

The North Dakota Senate today brought to the floor HB1362, which contains the expansion of the state Medicaid program originally mandated by Obamacare. The Supreme Court, however, ruled that the states get a choice. With a lot of Republicans saying they dislike the bill but will vote for it, the bill passed on a 33-14 vote.

The expansion was actually a part of Governor Jack Dalrymple’s Human Services budget, so there’s little doubt he’ll be signing it into law.

“Employers most provide insurance or pay penalties up to $3,000 per employee,” Senator Judy Lee, the bill’s carrier on the floor, said. “Not expanding Medicaid means lower paid employees become the responsibility of their employers. I don’t want to tell North Dakota employers they will have to pay large penalties.”

But there was plenty of passionate opposition to the legislation in the chamber.

“I’d love to use this bill to send a message to Washington, but Washington doesn’t care.” said Senator Dick Dever. “I’m going to vote for this, but I don’t like it.”

Senator Howard Anderson said that he doesn’t like the bill, and wasn’t voting for it. “The feds will not change anything or back off until we stop saying ‘send us the money and rub our tummy,” he said.

Perhaps the most passionate opposition came from Senator Margaret Sitte. “Each legislator who votes yes will be committing to billions of dollars in new state and federal tax increases,” she said in a fiery speech. “Each person who votes yes is complicit in the nation’s spending problems.”

There was even some outright lies on the floor of the Senate. “This has been scored as actually reducing debt,” said Senator Tim Mathern referring to widely-debunked calculations about the supposed cost savings of Obamacare. He also attacked the notion that the expansion of Obamacare is not “socialism.” He noted that the bill does not require the state to employer doctors or build hospitals.

Group Health Insurance in North Dakota
  • Eligible individuals with health problems may not be denied coverage or charged more than others.
  • Life changes related to family or job loss may entitle the policy holder to special opportunities for group health coverage.
  • Newborns, adopted, and disabled minors have special coverage opportunities.
  • Employers may apply a wait period before offering coverage.
  • HMOs may impose an affiliation period.
  • Pre-existing conditions have limits on protection.
  • Six months of medical history before coverage began may be reviewed for pre-existing conditions.
  • In the case of pre-existing conditions, an exclusion period of up to 12 months may apply.
  • If continuous coverage is maintained with no breaks over 63 days, the policy holder is entitled to creditable coverage.

Small Business Health Insurance in North Dakota

  • Small businesses with fewer than 50 may not be denied small group health insurance and providers must offer standardized plans.
  • Coverage may not be cancelled because of sickness within the insured group.
  • Businesses with under 25 employees have limits on the variances of their premiums.
  • For groups made of more than 25 people, there are no limits.

Self-Employed Health Insurance in North Dakota

  • The self-employed may not purchase small group coverage.
  • For regulations which apply to professional or trade associations offering group health insurance, contact the North Dakota Department of Insurance.

North Dakota Department of Insurance 
600 East Boulevard 
Bismarck, ND 58505
(701) 328-2440

Individual Health Insurance in North Dakota

  • Individual providers may deny coverage based on health problems.
  • If denied coverage, an applicant may buy insurance from Comprehensive Health Association of North Dakota (CHAND).
  • The same applies to HIPAA eligible applicants.
  • Providers must offer basic and standard plans.
  • In the case of a pre-existing condition, an elimination rider may be attached to a policy.
  • Exclusion periods of up to 12 months may apply.
  • Coverage may not be cancelled because of sickness.
  • No limits apply to the cost of an individual plan.

North Dakota Health Care Programs

  • The Comprehensive Health Association of North Dakota (CHAND) provides health insurance to HIPAA eligible applicants and to residents denied coverage elsewhere.
  • A few programs for low income residents include Medicaid, Healthy Steps and Caring Program for Children.
Location Status of State Exchange Decision Medicaid Expansion Decision Executive Activity
North Dakota Default to Federal Exchange Supports1

North Dakota Health Care

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