In a recent government meeting, lawmakers discussed two significant bills aimed at improving health insurance coverage for North Dakota residents. The first, Bill Draft Number 68, proposes that health benefit plans must include all amounts paid by enrollees towards prescription drugs when calculating out-of-pocket maximums. This change is expected to impact premiums, with an estimated increase of 1.1%, translating to approximately $8.7 million for the upcoming biennium. The bill specifically addresses the limitations of co-payments in the grandfathered PPO basic plan, where such payments currently do not count towards the out-of-pocket maximum.

Rebecca Fricke, Executive Director of the Public Employees Retirement System (PERS), highlighted that the bill aims to ensure compliance with high deductible health plans while exempting members until they meet their minimum deductible. The discussion revealed that the majority of PERS members are enrolled in the grandfathered plan, which has unique co-payment rules compared to non-grandfathered plans.

The second bill, Bill Draft Number 75, seeks to eliminate cost-sharing requirements for diagnostic and supplemental breast examinations. This legislation would prevent members from incurring out-of-pocket costs for these essential services, which are crucial for early cancer detection. The financial impact of this bill is estimated at a half-percent increase in premiums, amounting to over $4 million for the next biennium.

Supporters of both bills argue that they will ultimately save costs by promoting early detection and treatment of chronic illnesses and reducing the financial burden on patients with high medical expenses. However, concerns were raised about the potential long-term implications for insurance premiums and the overall cost of healthcare.

The committee voted to move both bills forward for further consideration, reflecting a commitment to enhancing healthcare access and affordability for North Dakota residents.