The North Dakota State Legislature's House Political Subdivisions Committee convened on March 20, 2025, to discuss a significant legislative management study focused on health care mandates. The meeting highlighted concerns over the rising costs of health care and the implications of existing and proposed mandates on insurance premiums.

Senator Jeff Bard introduced Senate Bill 2249, which aims to conduct a study on health care mandates, particularly addressing the controversial practice of step therapy. Step therapy requires patients to try less expensive medications before being approved for more costly treatments, often leading to delays in necessary care. Bard emphasized the need for clarity on whether such practices constitute mandates and how they affect patient care and costs.

Megan Rubin from Blue Cross Blue Shield of North Dakota expressed strong support for the study, citing the escalating costs of health care in the state. She noted that North Dakota has seen numerous proposed mandates this legislative session, which could lead to significant financial burdens on policyholders. Rubin argued that many existing mandates are outdated and do not reflect current medical standards, further complicating the cost landscape for insurers and consumers alike.

Eric Spencer, president of the Greater North Dakota Chamber, echoed these sentiments, stating that health care costs are a top concern for businesses across the state. He highlighted the unsustainable trajectory of health insurance premiums, which have seen increases between 6.3% and 15.3% in the past year alone. Spencer urged the committee to consider the broader economic implications of health care costs on employers and employees, particularly in relation to teacher salaries and local taxes.

The committee's discussions underscored the complexity of health care mandates and their impact on affordability and access to care. As the study moves forward, it aims to provide insights into the economic effects of these mandates and explore potential reforms to improve the health care landscape in North Dakota. The outcomes of this legislative study could shape future policies and address the pressing issue of health care affordability in the state.