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Concerns grow in North Dakota about increased insurance costs, medical debt

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Concerns grow in North Dakota about increased insurance costs, medical debt


BISMARCK — North Dakota health care organizations and insurance regulators are sounding a warning about the potential increase in out-of-pocket premium costs for those using the Affordable Care Act marketplace for their health insurance needs.

Some of the concern stems from changes to the ACA marketplace included in the latest version of the “One Big Beautiful Bill” covering enrollment, personal information verification and eligibility requirements.

Another area of concern is that expanded tax credits for those on the ACA marketplace will expire at the end of the year. Talk of an extension of those credits was not included in the latest formulation of the legislation currently being reviewed by the U.S. Senate.

Concerns over rising costs, loss of coverage

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About 50,000 people get their health insurance through the ACA marketplace in North Dakota, according to the state’s Office of the Insurance Commissioner.

Roughly 90% of those individuals are eligible for the expanded tax credits established during the pandemic in 2021.

Loss of these tax credits would lead to ACA insurance premiums rising on average by 75%, according to the health care information nonprofit KFF.

Without those credits, individuals would either need to pay the extra premium cost themselves or possibly lose coverage if they can’t afford the monthly payments.

“We know people are going to lose coverage,” said Tim Blasl, president of the North Dakota Hospital Association. “What that exactly looks like for North Dakota, we’ve got to work through that.”

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People would still get care, Blasl said, but more uninsured means less prevention and more people showing up in emergency rooms.

This increases medical debt for consumers and for hospitals if people can’t pay themselves.

“So, there’s a concern of an increase in bad debt, and how does that impact access to health care long term? How does that impact hospital financials long term? That’s something we are really concerned about,” Blasl said.

The Congressional Budget Office estimates 700,000 people could lose coverage nationally due to changes related to enrollment, and a further 3 million could become uninsured because of increased eligibility requirements.

The CBO said the expiration of the enhanced premium tax credits will lead to 4.2 million more uninsured people nationwide by 2034.

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Roughly 45,000 people in North Dakota on the ACA marketplace would pay higher premiums or drop coverage if they can’t afford it.

On June 20, a statement from the Center for Medicare and Medicaid Services said it is finalizing a rule included in the legislation that would lower the cost of ACA premiums by 5% on average, crack down on improper enrollments and rein in wasteful spending.

The statement said that in 2024, about 5 million people nationwide were potentially improperly enrolled on the ACA marketplace.

U.S. Rep. Julie Fedorchak, R-ND, said of the ACA changes included in the current legislation that, “Change is hard, change is going to require people to pay attention and make sure they’re properly enrolling and following the rules.”

Rep. Julie Fedorchak speaks Friday, Feb. 14, 2025, at Northern Cass High School in Hunter, North Dakota.

Anna Paige / The Forum

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Fedorchak said the program needs to be fixed so it can exist long-term amid federal budget and federal debt constraints.

The legislation could pass the Senate within the next week, then return to the House of Representatives for approval. President Donald Trump is pressing lawmakers to get the final legislation to his desk by July 4.

As for the expanded tax credits, Fedorchak said this may be taken up in another set of legislation in the second half of this year.

“There are concerns about how this will impact people and their insurance and maintaining their insurance, and there are also concerns about the cost to the federal government, which is about $350 billion to extend it in its current form,” Fedorchak said.

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“So it’s about balancing those two concerns and finding the best path forward.” Fedorchak said, “We don’t want a bunch of people going off their insurance and or losing their insurance or choosing not to purchase insurance, because that’s costly to the health care system, but at the same time, you know, some of the program levels are pretty generous.”

Rural impacts, rising medical debt

Impacts from the changes and expiration of tax credits are likely to be felt more acutely in rural parts of North Dakota.

According to 2024 data, nearly 27,000 of those on the ACA in the state lived in rural areas compared to around 16,000 in urban areas.

Brad Gibbens, a board member of the North Dakota Rural Health Association and former director of the Center for Rural Health at the University of North Dakota, said a higher percentage of people in rural areas are not insured through employers.

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Gibbens also said many of those on ACA plans receiving the subsidies are also likely getting food assistance through the Supplemental Nutrition Assistance Program, which is also being reformed and cut in the legislation.

“Both of those programs are being cut back so there’s going to be a profound effect in rural areas,” Gibbens said.

Those cuts will not only impact individuals who lose coverage, but also rural hospitals that treat patients in their ERs.

“They’re going to be coming in through the ERs when they’re sicker, when we would have liked to have seen them earlier to address an issue, rather than when they come back and it’s more acute,” Gibbens said. “There isn’t any money then, to treat them, so that comes back as more bad debt for the hospital.”

Gibbens said the moves are a “real step backwards” and would lead to significant negative impacts on the health of individuals but also on the financial viability of rural hospitals and clinics.

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Centrist think tank Third Way published a report June 23 examining the impacts on health care from changes in the One Big Beautiful Bill and estimated 5.4 million more people would be pushed into medical debt nationwide, increasing total medical debt by $50 billion.

Former Democratic-NPL U.S. congressman for North Dakota and former insurance commissioner Earl Pomeroy said the health care cuts in the One Big Beautiful Bill are a “common budget trick” made to pay for extending prior Trump tax cuts.

“They haven’t lifted a finger to keep health insurance affordable, and as a result, premiums will soar,” Pomeroy said. “Everyone knows higher health insurance premiums really hurt family budgets.”

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At the end of May, the National Association of Insurance Commissioners, currently led by North Dakota Insurance Commissioner Jon Godfread, sent a letter to both U.S. Senate and House majority and minority leaders highlighting changes to the ACA marketplace.

The letter said the potential expiration of the tax credits would have a “negative impact on insurance markets” and the “health care system as a whole.”

The NAIC letter said the rule changes would lead to fewer individuals covered and market disruptions as soon as 2026, and that the changes do not allow sufficient time for insurers, regulators and consumers to prepare.

The letter also stated the new eligibility requirements would prevent many consumers from getting insurance promptly, particularly if they lose jobs or their income changes.

Since 2020, overall enrollment on the ACA marketplace in North Dakota increased by about 87%.

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North Dakota ranks 15th in per capita spending on health care, according to data compiled by KFF.

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North Dakota highlights nearly 10 Years of victims’ constitutional rights during National Crime Victims’ Rights Week

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North Dakota highlights nearly 10 Years of victims’ constitutional rights during National Crime Victims’ Rights Week


FARGO, N.D. (Valley News Live) – This week, communities across the country are recognizing National Crime Victims’ Rights Week, an annual observance that has challenged the nation to confront and remove barriers to justice for crime victims since 1981.

This year’s observance runs April 19–25, led by the U.S. Department of Justice’s Office for Victims of Crime.

For North Dakota, the week carries special significance. In November 2016, North Dakota voters approved Marsy’s Law, known as Measure 3, with roughly 62% voter approval. The constitutional amendment took effect Dec. 8, 2016, guaranteeing crime victims the right to be notified, to be heard, and to be treated with dignity throughout the legal process.

“National Crime Victims’ Rights Week is a time to call attention to just how far our state has come in providing victims of crime with constitutional rights,” said a spokesperson for Marsy’s Law for North Dakota. “North Dakotan crime victims have now had a voice in the justice process for the last 10 years, which is a milestone we’re proud to celebrate this year with survivors and advocates from across the country.”

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A Voice for Victims

Holly Wethor knows firsthand what it means to finally feel supported by the justice system. As a victim advocate, she has seen Marsy’s Law change lives — including her own.

“You gain so much of your self-worth back, and you just see a clearer and brighter picture,” Wethor said. “I wish more people would learn about Marsy’s Law and learning through the courts that they can go through this and that they’re not alone and they can have that advocacy.”

Wethor’s message reflects what advocates across North Dakota say is the law’s most powerful impact, reminding victims they do not have to navigate the justice system alone.

Decades of Advocacy in North Dakota

The push for victims’ rights in North Dakota did not begin with Marsy’s Law. Advocates have been fighting for survivors for nearly five decades.

In 1978, the North Dakota Council on Abused Women’s Services, known as NDCAWS, began as an informal gathering of advocates from five crisis intervention centers across the state.

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Around the same time, the Coalition Against Sexual Assault in North Dakota, or CASAND, was formed to address the statewide need for education, networking, and legislative change surrounding sexual assault.

Resources for Victims

If you or someone you know is a victim of domestic or sexual violence, the following resources are available:

  • North Dakota Domestic & Sexual Violence Coalition: (701) 255-6240
  • National Domestic Violence Hotline: 1 (800)799-7233

Copyright 2026 KVLY. All rights reserved.



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Hawks Split Friday Doubleheader against NDSU and Omaha – University of North Dakota Athletics

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Hawks Split Friday Doubleheader against NDSU and Omaha – University of North Dakota Athletics


GRAND FORKS, N.D. – The North Dakota softball team went 1-1 on Friday, falling to Omaha 9-0 in the first game and defeating North Dakota State 2-0 in the nightcap from Albrecht Field. The Hawks now sit at 26-21 overall and 3-9 in Summit League play on the season.

It was a tale of two games for UND, from getting shutout in game one to doing the shutting out in game two. Chloe Bethune was 3-for-4 on the day with a walk, reaching base four times.

Game 1 – Omaha 9, UND 0

UND was outhit 8-2, with the Hawks hits coming from Tyler Price and Bethune. NoDak had three total base runners in the contest.

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Unity Nelson took the loss in the circle, falling to 9-8 on the season. The sophomore went 1.2 innings and gave up seven earned runs on just three hits, with five walks. Camryn Lasota came in for relief, throwing a season-high 3.1 innings, giving up two earned runs, five hits, one walk with one strikeout.

How It Happened

Both teams went down in order in the first inning, but Omaha struck with seven runs in the second on just four hits. Following a double and two walks, Sammy Schmidt hit a no-out double to right field, bringing home Katherine Johnson and Marra Cramer to take a 2-0 lead.

Nelson recorded the first out of the inning on an Ava Rongisch pop up, before throwing a wild pitch which allowed Alyson Edwards to score to make it 3-0. Following two more walks and a Taylor Sedlacek sac fly, UND was down 4-0. The Mavs scored three more in the inning, headlined by a Bailey Sample two-out double. NoDak trailed 7-0 after three.

The Mavericks scored two more in the top of the third to open up a 9-0 lead. UND got its first hit in the bottom of the fourth on a Price infield single, but the Hawks could not get anything going offensively, falling 9-0 in the first game.

Game 2 – UND 2, NDSU 0

Game two was the Tegan Livesay show, as the junior tossed her 13th complete game and fifth complete game shutout of the season, improving to 12-8 in 2026. She went 7.0 innings, surrendering just six hits and three walks with five huge punchouts. She recorded nine groundouts and threw 131 pitches. Livesay left 10 Bison stranded on base.

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The Hawks scored two runs through the first two innings, first on a Bethune RBI single to center field in the bottom of the first, which was followed by an RBI double down the left field line from Makenna Alexander in the bottom of the second.

The hit battle was even at 6-6 in the contest, led by Bethune who went 2-for-2 at the plate. Alexander, Taya Hopfauf, Katelyn Neumayer and Aleksia Severson each poured in a hit as well.

How It Happened

Livesay was weaving in and out of traffic all night, battling out of a bases loaded jam in the top of the first. Amai Hanta from NDSU walked to start the game and stole both second and third base to give the Bison a runner on third with no outs. Livesay recorded a massive strikeout on Star Cortez, which was followed by a walk to Bella Dean, setting up runners on the corners with one out.

Jessica Delatorre lined out to Severson for the second out, before Lileigh Nieto walked to load up the bases. Mya Boos grounded out into a 6-4 fielders choice to end the frame on some nifty glove work from Severson to keep it at 0-0.

Alexander and Price both struck out to start the second inning, before Hopfauf and Neumayer both singled. Jaedyn Valdez followed that up with a hit-by-pitch, loading up the bases for Bethune. The sophomore came through with a massive single up the middle, giving UND a 1-0 lead.

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Livesay left two stranded in the second inning, surrendering a leadoff infield single to Taylinn Warren. Warren then advanced to second base on a passed ball, but Livesay got Zoe King to strikeout swinging next.

The next batter grounded out to Livesay, before another infield single, this one by Hanta to put runners on the corners. Livesay got Cortez to groundout to first base, where Neumayer took it to the bag for the 3U inning ending putout.

In the bottom of the second, Brooklyn Morris reached on a one-out walk and advanced to second base on a wild pitch. Alexander then belted a ball down the third base line to bring home Morris, giving NoDak a 2-0 lead after two.

Livesay sat down the Bison 1-2-3 in the third and fourth innings before leaving two stranded in the top of the fifth. Hanta and Cortez both logged one-out singles and executed double steals, to give the Bison second and third with one out. Livesay got Dean to line out to short, before punching out Delatorre to get out of the jam.

NoDak stranded a runner on second base in the top of the sixth, with a chance to close it out in the top of the seventh. Livesay sat down Ella Claus, before allowing an infield single to Hanta, sending the tying run to the plate for the Bison.

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Cortez was able to reach safely on a fielding error by Livesay, giving NDSU runners on first and second with one out. The junior pitcher did not flinch, striking out Dean on a 3-2 count to make it two outs. Livesay completed the complete game shutout, getting Delatorre to pop out to second base, as UND secured its third-straight win over NDSU.

Game two of the series will take place tomorrow at 1 p.m. on Midco Sports.

For more information on North Dakota Softball, follow on social media @UNDsoftball or visit FightingHawks.com.

 





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Glatt to retire from ND Department of Environmental Quality; Armstrong thanks him for 43 years of service

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Glatt to retire from ND Department of Environmental Quality; Armstrong thanks him for 43 years of service


BISMARCK, N.D. – Gov. Kelly Armstrong today thanked North Dakota Department of Environmental Quality (DEQ) Director Dave Glatt for his 43 years of service to the state as Glatt announced his retirement as the first – and only – director of DEQ since it became a standalone agency in 2019. His retirement is effective July 31.

“Dave has dedicated more than four decades of his life to protecting North Dakota’s air, land and water with a regulatory approach that boils down to one simple rule: follow the science,” Armstrong said. “He rejected federal overreach and ideology-based regulation, instead holding firm to a cooperative, common-sense approach that allows North Dakotans to enjoy some of the cleanest air and water in the country as our economy thrives. We’ll miss Dave’s leadership, his expertise and his wry sense of humor. We thank him for his exceptional service and wish him all the best in retirement.”

Glatt was appointed DEQ director in May 2019 by then-Gov. Doug Burgum and reappointed by Armstrong in 2024. Prior to that, he served as chief of the North Dakota Department of Health’s Environmental Health Section from 2002 to 2019. He also previously served as the section’s Division of Waste Management director, interim director of Consolidated Laboratories, Division of Water Quality assistant director, and Groundwater Protection Program manager. 

During his long career in state government, Glatt helped implement the Safe Drinking Water Act in North Dakota and was the state project manager for an EPA Superfund project to address high arsenic levels in groundwater in southeastern North Dakota. Through collaboration with government at all levels, industry and citizens of the state, Glatt helped ensure that North Dakota remains a clean air state, maintains high regulatory standards and leads through the efficient implementation of all environmental protection programs.

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“It has been a privilege to work alongside so many dedicated professionals and North Dakotans who care deeply about protecting our shared environment,” Glatt said. “They made this work enjoyable, rewarding and meaningful, and I’m deeply grateful.”

Born in Valley City and raised in Milpitas, Calif., Glatt graduated from North Dakota State University where he earned a bachelor’s degree in biology and a master’s degree in environmental engineering. He briefly worked for the Los Angeles Flood Control District before returning to North Dakota in 1983, joining the Department of Health.

The 2017 Legislative Assembly passed legislation separating the Environmental Health Section from the Department of Health to create the standalone DEQ. On April 29, 2019, DEQ became an independent agency after all programs completed a federal review and approval process. 

Currently, DEQ has a two-year total budget of $141.8 million and is authorized for 175 full-time employees in six divisions: Air Quality, Chemistry, Municipal Facilities, Waste Management, and Office of Director. 



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