BISMARCK — Officials disagreed Wednesday about what the financial impact of federal health care reform will mean in North Dakota.
A spokesman for Sen. Kent Conrad, D-N.D., said the federal government, not the states, will be “picking up practically the entire tab” to expand Medicaid under the new law.
But state Rep. George Keiser, R-Bismarck, stands by his statement that the new federal health care law will increase costs for North Dakota families by about $1.1 billion over the next 10 years.
Conrad spokesman Chris Gaddie sent out an e-mail Wednesday responding to a story where Keiser discussed increased costs expected by the state.
Under the most conservative estimate, the state will assume a $32 million Medicaid cost increase, Gaddie said. The total increase in spending from 2014 to 2019 is estimated to be $627 million, with $32 million for the state and $595 million for the federal government, Gaddie said.
“It’s also important to note that an additional 28,800-plus North Dakotans will be enrolled under that scenario, meaning thousands more of our friends and neighbors will have badly needed health insurance,” he said.
Under a more aggressive scenario that would include greater outreach to the state’s uninsured, the numbers change slightly, Gaddie said. Estimates indicate more than 40,000 North Dakotans would be covered at a cost of $57 million to the state, he said. The federal share under this scenario drops slightly to 92.5 percent of the total $766 million cost, he said.
“Under either scenario, however, the federal government is picking up the lion’s share of the cost of expanding Medicaid, while tens of thousands of North Dakotans will benefit,” Gaddie said.
Keiser said Wednesday that his numbers came from the testimony of state agency officials, “and that’s all I can say. I trust them.”
John Bjornson of the state Legislative Council explained the $1.1 billion total comes from the following numbers:
- $12.4 million for the Insurance Department, not including information technology costs.
- $106 million for the Department of Human Services Medicaid expansion, with other costs possible.
- $8.9 million for the North Dakota Public Employees Retirement System, assuming all covered individuals remain in grandfathered plans through 2010-2019.
n $2.7 million for political subdivisions, assuming all covered individuals remain in grandfathered plans through 2010-2019.
- $983 million incurred by Blue Cross Blue Shield consumers, assuming all covered individuals remain in grandfathered plans through 2010-2019.
The extra costs in the last three items stem from per-contract reform mandates, such as dependents now being allowed to remain on their parents’ plans until age 26 and no more lifetime maximums, Bjornson said.
Keiser said Conrad’s office should look at the documentation for how the numbers were reached.
“I encourage them to take our summary apart and tell us where we’re wrong, where they are going to cover these costs that have been identified by the state,” Keiser said. “I don’t think perhaps that they fully appreciate the degree of analysis that our state departments have done.”
When reached late Wednesday, Gaddie said he would respond today after taking time to review the numbers.
Also Wednesday, Rep. Rick Berg, R-Fargo, sent out a statement reaffirming his opposition to the health care law. Berg is challenging Rep. Earl Pomeroy for a seat in the U.S. House.
Berg, who serves on the interim Industry, Business and Labor Committee with Keiser, said the $1.1 billion estimate by the committee “comes as an unfunded federal mandate that would be an additional cost to North Dakotans on top of the federal costs.”