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North Dakota HHS warns Medicaid costs and enrollment shifts will shape next budget
Summary
Department of Health and Human Services officials told the House Appropriations Committee that Medicaid enrollment declines since the COVID-era public health emergency, the end of enhanced FMAP, and ongoing utilization by higher-need enrollees are driving changes in federal funding and state budget pressure for the coming biennium.
The Department of Health and Human Services presented a high-level budget overview to the House Appropriations Committee Tuesday, telling lawmakers the agency’s large role in state services makes its budget central to near-term fiscal planning.
“For the record, my name is Dirk Wilkie. I’m the interim commissioner of Health and Human Services,” Wilkie said, explaining the agency’s strategic framework and scope of services. He described HHS as “the largest agency in the state and we have the largest budget,” and said that carries both responsibility and opportunity.
Why it matters: Medicaid and related entitlement programs make up the bulk of HHS spending, and changes that occurred during and after the COVID-19 public health emergency have altered both federal funding streams and the state’s cost exposure. That shift will be a major driver of the department’s 2025–27 budget conversation.
The department’s CFO, Donna Auckland, told the panel the…
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