North Dakota faces $1.4B Medicaid funding cut from proposed federal bill

A significant discussion at the North Dakota Legislature's recent meeting centered on the potential impacts of the proposed "1 Big Beautiful Bill Act," which could drastically reduce federal funding for key programs in the state. The memorandum presented highlighted two main areas of concern: the anticipated cuts to Medicaid and changes to the Supplemental Nutrition Assistance Program (SNAP).

The proposed legislation, which has already passed the U.S. House of Representatives, could lead to a staggering $1.4 billion reduction in federal Medicaid funding for North Dakota over the next decade. This represents a 12% cut to the state's projected federal share. Key provisions include a new mandatory work requirement for able-bodied adults and increased cost-sharing for Medicaid expansion enrollees. The bill is expected to reduce Medicaid enrollment in North Dakota by 18% by 2034.

In addition to Medicaid, the bill proposes significant changes to SNAP, shifting more financial responsibility to the state. Currently, the federal government covers all SNAP benefits, but the new legislation would increase state cost-sharing for both benefits and administrative costs. This could cost North Dakota an estimated $18 million per biennium, adding to the existing $260 million the state receives for the program.

The meeting also addressed recent federal funding rescissions, which have already resulted in approximately $100 million in cuts for North Dakota. These include terminations of grants for health services and infrastructure projects, impacting various communities across the state. The legislature has taken steps to mitigate some of these losses, such as providing a line of credit for wastewater projects affected by FEMA funding cuts.

As the "1 Big Beautiful Bill Act" continues to evolve in Congress, state officials are urged to monitor its developments closely, as the final version may bring further changes that could significantly affect North Dakota's budget and services.