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ND Lawmakers to re-open debate on Medicaid expansion

The chairman of an interim Legislative committee studying health care says he’s not sure the state will continue Medicaid expansion – at least in its current form.

In 2013, the state Legislature passed Medicaid expansion – to help lower income North Dakotans receive health care through the Affordable Care Act, or Obamacare. It was completely paid for by the federal government. However, lawmakers put a 2017 sunset clause on it – because the state would then be required to start picking up some of the tab. The state has contracted with Sanford Health Insurance to run that program.  More than 20,000 North Dakotans are covered under this program.

"The state becomes 10 percent responsible in 2017," said Rep. George Keiser (R-Bismarck), chairman of the Interim Health Care Reform Review Committee. "That will be a significant amount of money."

Keiser chairs the interim Health Care Reform Review Committee. He says with the state’s budget constraints, everything is on the table.

"I clearly recognize it's unlikely we will continue the current contractual arrangement," Keiser said. "There will either be modifications, or a change in direction."

Keiser says the options would include making changes to that contract – and that means changes to the reimbursement hospitals and doctors receive – or having the state Human Services Department take it over.

"Some states, Tennessee, Arkansas, have looked at innovative approaches," Keiser said. "They're going out with such things as voucher programs to the (insurance) exchanges."

State Human Services director Mggie Anderson says as her department is working on its budget proposal, she plans to continue the Medicaid expansion program as is.

"It's the 20,000 people covered under the program," Anderson said. "They currently wouldn't have access to the advanced premium tax credits through the marketplace, if we would end Medicaid expansion."

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