North Dakota 2025-2026 Regular Session

North Dakota Senate Bill SB2348

Introduced
1/22/25  
Refer
1/22/25  
Report Pass
2/13/25  
Engrossed
2/18/25  
Refer
2/21/25  
Report Pass
3/26/25  
Enrolled
4/2/25  

Caption

AN ACT to create and enact a new section to chapter 15-10 and a new chapter to title 50 of the North Dakota Century Code, relating to the acceptance of health care sharing ministries by an institution of higher education and health care sharing ministries' exemptions from insurance laws and regulations.

Summary

SB 2348 creates a new state law recognizing participation in a health care sharing ministry as satisfying a college or university health coverage requirement for most students in North Dakota. The bill expressly excludes international students on J, F, or M visas, who must still maintain health insurance that meets federal visa rules and applicable State Board of Higher Education policy. It also adds a new chapter to Title 50 defining what qualifies as a health care sharing ministry. Under the bill, a health care sharing ministry must be a 501(c)(3) nonprofit with members sharing common ethical or religious beliefs, must facilitate rather than insure the sharing of medical expenses, must provide monthly sharing information, must undergo an annual independent audit, and must include a written disclaimer stating that it is not insurance and does not guarantee payment of medical bills. The bill further provides that a qualifying health care sharing ministry is not considered to be engaging in the business of insurance and is exempt from insurance laws and regulations.

Impact

The bill changes North Dakota law in two main ways: it gives institutions of higher education authority to accept health care sharing ministry participation in place of traditional health insurance for student coverage requirements, and it creates a statutory exemption from insurance regulation for qualifying ministries. This affects colleges and universities, students who use health care sharing ministries, and the insurance regulatory framework by carving these organizations out of the definition and oversight of insurance entities, while preserving separate federal and institutional requirements for international students.

Sentiment

The bill appears to have broad support overall, passing the Senate 44-1 and the House 72-19. The vote margins suggest general agreement with the bill’s approach to recognizing health care sharing ministries and limiting insurance regulation for them, though the House vote shows more opposition than the Senate. No committee transcript is available, so the record reflects support primarily through the strong floor votes rather than detailed debate.

Contention

The main point of contention is likely whether health care sharing ministries should be treated as an acceptable substitute for health insurance and whether they should be exempt from insurance laws. Supporters appear to favor religious liberty, consumer choice, and reduced regulatory burdens, while opponents likely worry about consumer protection, the lack of guaranteed payment, and whether students relying on these ministries have adequate coverage. The bill also draws a clear line for international students, who remain subject to federal visa insurance requirements, indicating concern about compliance with existing federal rules.

Companion Bills

No companion bills found.

Previously Filed As

ND SB2348

AN ACT to create and enact a new section to chapter 15-10 and a new chapter to title 50 of the North Dakota Century Code, relating to the acceptance of health care sharing ministries by an institution of higher education and health care sharing ministries' exemptions from insurance laws and regulations.

ND HB21

Enact the Health Care Sharing Ministries Freedom to Share Act

ND HB1437

Academic tenure policy at institutions of higher education.

ND HB1437

AN ACT to create and enact a new section to chapter 15-10 of the North Dakota Century Code, relating to academic tenure policy at institutions of higher education.

ND HB271

Health Care Sharing Ministries & Insurers

ND HB1145

Displays of the ten commandments in state educational institutions and public schools.

ND HB1145

A BILL for an Act to create and enact two new sections to chapter 15-10, a new section to chapter 15.1-09, and a new section to chapter 15.1-21 of the North Dakota Century Code, relating to displays of the ten commandments in state educational institutions and public schools.

ND HB1161

Funding for newly created full-time equivalent positions at institutions under the control of the state board of higher education.

ND HB1161

A BILL for an Act to create and enact a new section to chapter 15-10 of the North Dakota Century Code, relating to funding for newly created full-time equivalent positions at institutions under the control of the state board of higher education.

ND SB2392

The regulation of prohibited discriminatory practices; and to provide for a legislative management report.

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