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Published November 16, 2012, 11:30 PM

North Dakota won’t run health insurance market for now

Step could be taken in the future, spokesmen for Gov. Dalrymple say
BISMARCK – North Dakota is not planning to set up its own health insurance marketplace under the new federal health care law, although that step could be taken in the future, spokesmen for Gov. Jack Dalrymple said.

By: Dale Wetzel, Associated Press, INFORUM

BISMARCK – North Dakota is not planning to set up its own health insurance marketplace under the new federal health care law, although that step could be taken in the future, spokesmen for Gov. Jack Dalrymple said.

The health insurance “exchanges” are a key part of the Affordable Care Act, which was passed by Congress over Republican opposition two years ago and has since survived a U.S. Supreme Court challenge to its legality.

They are intended to offer a menu of health insurance plans for individual buyers and small businesses, and to provide subsidies for low- to middle-income customers to use in buying coverage.

States faced a Friday deadline for telling the federal Department of Health and Human Services whether they intended to set up their own exchanges or leave the job to the federal government.

Maggie Anderson, director of North Dakota’s Department of Human Services, called the federal agency Friday “to reiterate to them that the state doesn’t intend to move forward with its own exchange,” Dalrymple spokeswoman Jody Link said.

Advocates of setting up a state health insurance exchange have argued it would be more responsive to North Dakotans’ needs and questions than an organization run from Washington. A state exchange also might have more flexibility in designing health benefit plans, they say.

Opponents of a state exchange say the federal law leaves most decision-making authority in Washington’s hands, regardless of whether the state or federal government operates it. Taking on the job of running an exchange also could saddle state taxpayers with considerable administrative costs. That expense has been estimated at $10 million every two years.

The North Dakota House, during a November 2011 special session, decisively rejected a proposal to create a state exchange.

Dalrymple this week said the federal law gives states the option of applying later to run the exchanges in their states, after they have been established. The law sets a Jan. 1, 2014, deadline to have the marketplaces operating in all 50 states, a goal Dalrymple doubts can be met.

“I just don’t think that anybody believes that that’s going to be achieved. So I don’t think there’s any question that more flexibility is almost a certainty here,” the governor said. “There definitely is going to be a lot more information and a lot more that’s going to have to unfold here as we go forward.”

Rep. Al Carlson, R-Fargo, the House majority leader, said the Legislature may revisit the issue after its session begins in January and discuss another administrative option, called the “state partnership exchange,” which would allow the state to run some aspects of the health insurance exchange.

Anderson said the federal Department of Health and Human Services has provided “minimal guidance” about how the partnerships would operate.

“We would need a lot more information before the state would be in a position to say they partnership model ... would be an option,” Anderson said.


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