By: Mary Steurer
BISMARCK, N.D. (North Dakota Monitor) – The North Dakota House voted 55-37 on Wednesday in favor of a bill that some worry will lead to state employees paying health insurance premiums — though supporters say that is not the intention of the proposal.
Senate Bill 2160 would move the state’s insurance to a plan that offers benefits compliant with the federal Affordable Care Act.
Proponents say it will give the state more flexibility over plan designs, which are limited under the current plan.
This could save the state money at no extra cost to employees, said Rep. Jonathan Warrey, R-Casselton, the bill’s sponsor. Savings are especially important in light of rising health care costs, he added.
The House Appropriations Committee on Tuesday forwarded the bill with a 15-7 do-pass recommendation.
The bill is expected to cost $6.6 million for the 2025-2027 budget cycle, plus an additional more than $25 million for the 2027-2029 biennium, according to a fiscal analysis attached to the bill.
One of the biggest concerns voiced by critics is that the state would be able to start charging employees premiums. The state may be tempted to do so to offset the additional cost of the plan, opponents said. Under the current plan, the state cannot charge premiums.
Rep. Ben Koppelman, R-West Fargo, said the bill does not force premiums on employees and there’s no reason the state would need to in the future. The state would not have to charge employees premiums in order for the plan to be Affordable Care Act-compliant.
“I have no intention of charging a premium to the state employees,” Koppelman said.
During committee discussion, however, some lawmakers did indicate they’d like to see state employees contribute to health insurance.
Rep. Eric Murphy, R-Grand Forks, said that changing the plan is taking a big risk without assurance employees will prefer it. He said it’s not clear that the plan will save money.
People often take jobs with the state government for the benefits and stability, he argued.
Warrey said Senate Bill 2160 would also give employees more free benefits, such as preventive health care like colonoscopy screening and mammograms. It would allow co-pays to count toward out-of-pocket maximums.
Rep. Jim Kasper, R-Fargo, said that if employees take advantage of preventive care services the cost of the state plan will go down over time. They’ll be able to address health conditions before they become more severe and more costly, he reasoned.
According to Kasper, who said he has worked in employee benefits for 25 years, the private sector moved to Affordable Care-Act compliant plans long ago because they offer more flexibility.
“Grandfathered plans in my opinion are like dinosaurs,” Kasper said.
If the state saves money by changing the plan, it could reallocate those extra funds into raising wages for employees, said Koppelman. This could be positive for recruitment and retention, he said.
“Young individuals are looking for more dollars in the check,” Koppelman said.
Some state agencies have come out in opposition to the plan, Rep. Austen Schauer, R-West Fargo, noted on the floor.
The Office of Management and Budget, for example, has said that employees consider the current health plan an important benefit and worry about the new plan impacting North Dakota’s ability to attract state workers. The agency has also expressed concerns about how the state will fund the plan.
Schauer said the state should seek more thorough data about the proposal, including what an Affordable Care Act-compliant plan would cost and how many employees support the change.
The bill represents a “huge decision that needs to be studied with input from all stakeholders,” Schauer said.
The bill is expected to go to the Senate next for a concurrence vote.
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