North Dakota 2025-2026 Regular Session

North Dakota House Bill HB1248

Introduced
1/13/25  
Refer
1/13/25  
Report Pass
2/10/25  
Engrossed
2/13/25  
Refer
2/17/25  
Report Pass
3/21/25  
Enrolled
4/24/25  

Caption

AN ACT to amend and reenact section 54-03-28 of the North Dakota Century Code, relating to the cost-benefit analysis requirement for health insurance mandated coverage of services.

Summary

HB 1248 revises North Dakota’s process for considering bills that mandate health insurance coverage of services or require payment to specified providers. The bill requires the Legislative Management to identify such measures and ensure that a cost-benefit analysis is attached before the measure can be referred to or acted on by a committee. If a measure or amendment is found to impose a mandate without the required analysis, the committee must request one and may not proceed until it is provided. The bill also specifies the factors that must be included in the analysis: expected changes in the cost of the service, appropriate use of the service, administrative expenses for insurers and insureds, and the overall impact on health care costs. It directs the Legislative Council to contract with a private entity, using recommendations from the insurance commissioner, to prepare the analysis, with the insurance commissioner paying the cost of the contracted services.

Impact

HB 1248 amends section 54-03-28 of the North Dakota Century Code and strengthens procedural requirements for health insurance mandate legislation. It affects how the Legislature screens, processes, and debates bills that would expand mandated health coverage or provider payment obligations, and it adds a formal cost-benefit review step before committee action. The bill also ties the analysis process to the Legislative Management, Legislative Council, and insurance commissioner, and shifts the cost of the contracted analysis to the insurance commissioner.

Sentiment

The bill appears to have broad bipartisan support and little visible opposition. It passed the House and Senate by large margins, including unanimous or near-unanimous second-reading votes in the House and Senate, with only two dissenting votes on the final Senate vote. The voting pattern suggests general agreement with requiring more information and fiscal analysis before advancing health insurance mandate bills.

Contention

No committee testimony or transcript discussion was provided, and the vote history shows limited contention. The main policy issue is procedural rather than substantive: whether health insurance mandate bills should be subject to mandatory cost-benefit analysis before committee consideration, and who should pay for and prepare that analysis. Any disagreement likely centers on the added administrative burden, the role of private contractors and the insurance commissioner, and whether the process could slow or limit consideration of coverage mandates.

Companion Bills

No companion bills found.

Previously Filed As

ND HB1248

AN ACT to amend and reenact section 54-03-28 of the North Dakota Century Code, relating to the cost-benefit analysis requirement for health insurance mandated coverage of services.

ND HB1114

Health insurance benefits coverage of insulin drugs and supplies.

ND HB1114

AN ACT to create and enact a new section to chapter 26.1-36 of the North Dakota Century Code, relating to individual and group health insurance coverage of insulin drugs and supplies; and to amend and reenact section 54-52.1-04.18 of the North Dakota Century Code, relating to health insurance benefits coverage of insulin drugs and supplies.

ND SB2160

Health insurance benefits coverage provided by the uniform group insurance program; to provide an appropriation; to provide for a statement of legislative intent; and to provide an effective date.

ND SB2160

AN ACT to amend and reenact sections 54-52.1-01, 54-52.1-02, and 54-52.1-03.1 of the North Dakota Century Code, relating to health insurance benefits coverage provided by the uniform group insurance program; to provide an appropriation; to provide for a statement of legislative intent; and to provide an effective date.

ND HB1087

Licensing for administrators of life and health insurance and pharmacy benefit managers.

ND HB1087

AN ACT to amend and reenact sections 26.1-27-03 and 26.1-27.1-02 of the North Dakota Century Code, relating to licensing for administrators of life and health insurance and pharmacy benefit managers.

ND SB2190

Medical assistance benefits.

ND SB2190

A BILL for an Act to amend and reenact section 50-24.1-45 of the North Dakota Century Code, relating to medical assistance benefits.

ND SB2124

Insurance company definitions and examination records.

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