All Roll Calls
Yes: 184 • No: 93
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)
Became Law
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
Drug cost rules for self-insured plans
Self-insured employer health plans must follow these new drug cost-sharing rules through July 31, 2025. That means payments for your prescriptions are counted the same way as in insured plans, with the same limits on copay assistance. The Insurance Commissioner oversees compliance during this period.
How your drug payments now count
The law makes health plans count what you pay—or what others pay for you—for prescription drugs toward your cost-sharing and out-of-pocket tracking. But copay assistance can only reduce your copay. It cannot be used to meet your deductible or your out-of-pocket maximum, and you must tell your insurer when you use it. Plans cannot change your out-of-pocket limit or drug cost-sharing just because assistance is available. If you have a high-deductible plan with an HSA, these counting rules do not apply to the deductible until you meet the federal HSA minimum deductible. Grandfathered plans are not covered. These rules apply when federal law allows.
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
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
Filed with Secretary Of State 04/29
5/2/2025HouseSigned by Governor 04/29
5/1/2025HouseSent to Governor
4/28/2025HouseSigned by Speaker
4/28/2025HouseSigned by President
4/28/2025SenateSecond reading, passed, yeas 56 nays 37
4/24/2025HouseConcurred
4/24/2025HouseReturned to House (12)
4/21/2025HouseSecond reading, passed as amended, yeas 29 nays 18
4/21/2025SenateAmendment adopted, placed on calendar
4/21/2025SenateReported back amended, do not pass, placed on calendar 10 6 0
4/18/2025SenateRereferred to Appropriations
4/16/2025SenateReported back amended, do pass, amendment placed on calendar 11 3 2
4/15/2025SenateRereferred to Appropriations
3/24/2025SenateReconsidered
3/24/2025SenateSecond reading, passed as amended, yeas 30 nays 14
3/24/2025SenateAmendment adopted, placed on calendar
3/21/2025SenateReported back amended, do not pass, placed on calendar 4 1 1
3/20/2025SenateCommittee Hearing 11:00
3/10/2025SenateIntroduced, first reading, referred Human Services Committee
2/20/2025SenateReceived from House
2/20/2025SenateSecond reading, passed, yeas 69 nays 24
2/19/2025HouseAmendment failed, placed on calendar
2/19/2025HouseReported back amended, do pass, amendment placed on calendar 12 1 1
2/18/2025HouseCommittee 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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