BISMARCK – Federal health care reform will cost at least $1.1 billion in North Dakota in the next 10 years, a Republican lawmaker said Tuesday.
Rep. George Keiser, R-Bismarck, said the bill will cost at least $74,200 to cover each of the 15,000 North Dakotans uninsured due to situations such as pre-existing conditions and lifetime maximum.
It’s revenue “we’ll have to generate somewhere,” whether through increased insurance premiums or taxes, he said.
“Somebody is going to pay for it,” Keiser said. “North Dakotans deserve answers from the federal government on how our citizens and state can mitigate the substantial costs associated with the new health care law.”
However, Sen. Tracy Potter, D-Bismarck, who serves on the same committee, said North Dakota “benefits extremely well” from federal health care reform.
The Frontier State Amendment is a $650 million savings for North Dakota hospitals and doctors over 10 years by increasing Medicare reimbursement for them, he said.
“We will also benefit from the subsidies that go to low- and middle-income families and businesses because we are a low-wage state,” said Potter, who is challenging Gov. John Hoeven for a seat in the U.S. Senate.
Tim Blasl, vice president of the North Dakota Hospital Association, said the $650 million will be offset by other decreases in the reform bill.
Analysis found the estimated impact of health care reform on North Dakota hospitals will be $260 million, he said.
Four months after federal health care reform became law, North Dakota is still waiting to see what it means for the state.
The legislative Interim, Business and Labor Committee received updates Tuesday from insurance and health officials on the topic. They said questions will remain until the federal government more clearly defines wording in the law.
Insurance Commissioner Adam Hamm said health insurers who offer coverage in the individual and small-group markets must ensure their coverage includes the essential health benefits package for plan years beginning in 2014.
Although certain services are known to fall in this category, a complete definition has not been provided, he said.
There are also questions about the minimum loss ratio, which has to do with the claims companies pay out compared to the amount of premiums they collect. Hamm said the National Association of Insurance Commissioners is working on definitions to recommend to the U.S. Department of Health and Human Services.
He said his department is in the process of creating recommendations for the 2011 session.
Because North Dakota lawmakers meet every two years, many decisions need to be made in the next few months, Hamm said.
Keiser doesn’t think lawmakers will be able to address all of the health care regulations in the 2011 session.
“I can’t tell right now if we’ll need a special session or not,” he said. “I’m willing to bet a lot of money that we’re not going to have some of the major regulations developed prior to the end of our session.”
While federal health care reform expands accessibility, it doesn’t help lower costs, Keiser said. He and Rep. Jim Kasper, R-Fargo, asked what can be done to keep costs down in North Dakota.
Rod St. Aubyn, director of government relations for Blue Cross Blue Shield of North Dakota, said the company knows something has to be done to bend the cost curve.
“They’re trying to come up with what are our own home-growth solutions,” he said.
But with North Dakota’s aging population using more health care, it’s “going to be a real struggle for our state,” St. Aubyn said.
“We have to find some solutions to this,” he said.