North DakotaHB 12162025 Regular SessionHouseWALLET

AN ACT to create and enact a new section to chapter 26.1-36 of the North Dakota Century Code, relating to out-of-pocket expenses for prescription drugs; to amend and reenact section 26.1-36.6-03 of the North Dakota Century Code, relating to self-insurance health care plans; to provide for application; and to provide an effective date.

Sponsored By: Karen Karls (Republican)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Drug payment help counts toward patients’ limits

North Dakota health plans must count qualifying prescription payments toward patients’ out-of-pocket limits, deductibles, copays, and coinsurance. This includes payments by patients or others on their behalf, to the extent federal law and regulations allow. Drugs qualify when no generic exists. When a generic exists, access must follow prior authorization, step therapy, or the insurer’s expectations and appeals process. Plans cannot change cost-sharing, out-of-pocket limits, or benefit design based on whether drug payment help is available. For qualified high-deductible plans, the deductible requirement applies only after patients meet the federal minimum deductible, preserving health savings account eligibility. Public Employees Retirement System group health coverage follows these rules beginning January 1, 2026, regardless of contract dates. Other covered plans follow them January 1, 2026, or at their next renewal after that date.

Sponsors & Cosponsors

Sponsor

  • Karen Karls

    Republican • House

Cosponsors

  • Jared C. Hagert

    Republican • House

  • Dwight Kiefert

    Republican • House

  • Scott Wagner

    Republican • House

  • Josh Boschee

    Democratic • Senate

  • Dick Dever

    Republican • Senate

  • Ronald Sorvaag

    Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 184 • No: 93

House vote • 4/24/2025

Second reading, passed, yeas 56 nays 37

Yes: 56 • No: 37

Senate vote • 4/21/2025

Second reading, passed as amended, yeas 29 nays 18

Yes: 29 • No: 18

Senate vote • 3/24/2025

Second reading, passed as amended, yeas 30 nays 14

Yes: 30 • No: 14

House vote • 2/19/2025

Second reading, passed, yeas 69 nays 24

Yes: 69 • No: 24

Actions Timeline

  1. Filed with Secretary Of State 04/29

    5/2/2025House
  2. Signed by Governor 04/29

    5/1/2025House
  3. Sent to Governor

    4/28/2025House
  4. Signed by Speaker

    4/28/2025House
  5. Signed by President

    4/28/2025Senate
  6. Second reading, passed, yeas 56 nays 37

    4/24/2025House
  7. Concurred

    4/24/2025House
  8. Returned to House (12)

    4/21/2025House
  9. Second reading, passed as amended, yeas 29 nays 18

    4/21/2025Senate
  10. Amendment adopted, placed on calendar

    4/21/2025Senate
  11. Reported back amended, do not pass, placed on calendar 10 6 0

    4/18/2025Senate
  12. Rereferred to Appropriations

    4/16/2025Senate
  13. Reported back amended, do pass, amendment placed on calendar 11 3 2

    4/15/2025Senate
  14. Rereferred to Appropriations

    3/24/2025Senate
  15. Reconsidered

    3/24/2025Senate
  16. Second reading, passed as amended, yeas 30 nays 14

    3/24/2025Senate
  17. Amendment adopted, placed on calendar

    3/21/2025Senate
  18. Reported back amended, do not pass, placed on calendar 4 1 1

    3/20/2025Senate
  19. Committee Hearing 11:00

    3/10/2025Senate
  20. Introduced, first reading, referred Human Services Committee

    2/20/2025Senate
  21. Received from House

    2/20/2025Senate
  22. Second reading, passed, yeas 69 nays 24

    2/19/2025House
  23. Amendment failed, placed on calendar

    2/19/2025House
  24. Reported back amended, do pass, amendment placed on calendar 12 1 1

    2/18/2025House
  25. Committee Hearing 02:00

    1/27/2025House

Bill Text

  • Adopted by the House Industry, Business and Labor Committee

  • Adopted by the Senate Human Services Committee

  • Enrollment

  • HOUSE BILL NO. 1216 with Senate Amendments

  • INTRODUCED

  • Prepared by the Legislative Council staff for Representative Karls

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