North Dakota faces $1.4B Medicaid cuts under proposed 1 Big Beautiful Bill Act

In a recent meeting of the North Dakota Legislative Management, significant discussions centered around the potential impacts of proposed federal funding reductions, particularly from the "1 Big Beautiful Bill Act," which is currently under consideration in Congress. This legislation, which has already passed the U.S. House of Representatives, could lead to substantial cuts in federal entitlement programs, directly affecting North Dakota's Medicaid and Supplemental Nutrition Assistance Program (SNAP).

The proposed changes to Medicaid could result in a staggering $1.4 billion reduction in federal funding over the next decade, translating to a 12% cut in the state's projected federal share. Key provisions include a new work requirement for able-bodied adults and increased cost-sharing for Medicaid expansion enrollees. These changes are expected to reduce Medicaid enrollment in North Dakota by 18% by 2034, raising concerns about the health and well-being of many residents who rely on these services.

In addition to Medicaid, the bill proposes alterations to SNAP, shifting more financial responsibility to the state. Currently, the federal government covers all SNAP benefits, but the proposed changes would increase the state's share of both benefits and administrative costs, potentially costing North Dakota an additional $18 million per biennium. This comes at a time when the state already receives approximately $260 million from the federal government for SNAP.

The meeting also addressed recent federal funding rescissions that have already impacted North Dakota. Approximately $100 million in federal funding cuts have been realized, including $75.8 million from the Department of Health and Human Services, affecting various health programs. The termination of FEMA funding for infrastructure projects has also raised alarms, as it directly impacts community projects, including wastewater management in several towns.

As the legislative body continues to monitor these developments, the implications of the proposed federal funding changes remain a pressing concern for North Dakota residents. The discussions highlighted the need for ongoing vigilance as the state navigates potential funding cuts that could significantly affect public health and welfare programs. The committee plans to keep a close eye on the evolving situation, especially as the "1 Big Beautiful Bill Act" progresses through Congress.