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'False promise' or lifesaver? Insulin spending cap returns to North Dakota Legislature

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'False promise' or lifesaver? Insulin spending cap returns to North Dakota Legislature


BISMARCK — A bill introduced in the North Dakota House of Representatives could cap out-of-pocket insulin costs for some North Dakotans at $25 per month.

The bill also includes a monthly cap for insulin-related medical supplies of $25.

With insulin costing North Dakota residents billions of dollars each year,

House Bill 1114

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would provide relief for people on fully insured plans provided by individual, small and large group employers. People on self-funded plans would not be affected.

“I call insulin liquid gold,” Nina Kritzberger, a 16-year-old Type 1 diabetic from Hillsboro, told lawmakers. “My future depends on this bill.”

HB 1114 builds on

legislation

proposed during the 2023 session that similarly sought to establish spending caps on insulin products.

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Before any health insurance mandate is enacted,

state law

requires the proposed changes first be tested on state employee health plans.

As such, the legislation was altered to order the state Public Employees Retirement System, or PERS, to introduce an updated bill based on the implementation of a $25 monthly cap on a smaller scale.

The updated bill — House Bill 1114 — would bring the cap out of PERS oversight and into the North Dakota Insurance Department, which regulates the fully insured market but not the self-insured market.

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Employers that provide self-insured health programs use profits to cover claims and fees, acting as their own insurers.

Fully insured plans refer to employers that pay a third-party insurance carrier a fixed premium to cover claims and fees.

“It (the mandate) doesn’t impact the entire insurance market within North Dakota,” PERS Executive Director Rebecca Fricke testified during a Government and Veterans Affairs Committee meeting on Thursday, Jan. 9.

Blue Cross Blue Shield Vice President Megan Hruby told the committee that two-thirds of the provider’s members would not be eligible for the monthly cap, calling the bill a “false promise.”

“We do not make health insurance more affordable by passing coverage mandates, as insurance companies don’t pay for mandates. Policy holders pay for mandates in the form of increased premiums,” Hruby said.

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She touted the insurance provider having already placed similar caps on insulin products and said companies should be making those decisions, not the state government.

Sanford Health and the Greater North Dakota Chamber also had representatives testify against the bill.

Advocates for the spending cap said higher premiums are worth lowering the cost of insulin drugs and supplies.

“One of the first things that people ask me about is, ‘Why should I pay for your insulin?’ And my response is, ‘Why should I have to pay for your premiums?’” Danelle Johnson, of Horace, said in her testimony.

If adopted and as written, the spending caps brought by

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House Bill 1114

would apply to the North Dakota commercial insurance market and cost the state around $834,000 over the 2025-27 biennium.

According to the 2024 North Dakota diabetes report,

medical fees associated with the condition cost North Dakotans over $306 billion in 2022.

The state has more than 57,200 adults diagnosed with diabetes, and a staggering 38% have prediabetes — a condition where blood sugar levels are high but not high enough to cause Type 2 diabetes.

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Nearly half of those people are adults 65 years old or older.

North Dakotan tribal members were also found to be twice as likely to have diabetes compared to their white counterparts.

Peyton Haug joined The Forum as the Bismarck correspondent in June 2024. She interned with the Duluth News Tribune as a reporting intern in 2022 while earning bachelor’s degrees in journalism and geography at the University of Minnesota Duluth. Reach Peyton at phaug@forumcomm.com.





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North Dakota

North Dakota approves certificate of site compatibility for 400MWh BESS from NextEra Energy Resources

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North Dakota approves certificate of site compatibility for 400MWh BESS from NextEra Energy Resources






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Armstrong opens application period for Governor’s Band/Orchestra and Choral programs

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Armstrong opens application period for Governor’s Band/Orchestra and Choral programs


BISMARCK, N.D. – Gov. Kelly Armstrong today announced the opening of the application period for school, community and church bands, orchestras and choirs across North Dakota to apply to serve as the Governor’s Official State Band/Orchestra Program and Choral Program for the 2026-2027 school year. 

The Governor and First Lady will select the two groups from the applications received based on musical talent, achievement and community involvement. The governor may invite the groups to perform at official state functions held throughout the 2026-2027 school year, including the State of the State Address in January 2027 at the Capitol in Bismarck. 

Interested groups should submit an application with a musical recording to the Governor’s Office by 5 p.m. Monday, May 4. The Governor’s Band/Orchestra Program and Governor’s Choral Program will be announced in May. Please complete the application and provide materials at https://www.governor.nd.gov/governors-chorus-and-bandorchestra-program-application. 



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Greenpeace seeks new trial, claiming jury pool biased in case over Dakota Access Pipeline

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Greenpeace has asked for a second trial after a judge entered a $345 million judgment against the organization in a landmark case brought by the developer of the Dakota Access Pipeline.

The case “threatens to result in one of the largest miscarriages of justice in North Dakota’s history,” attorneys for the environmental group wrote in a brief filed last week.

After a three-week trial roughly a year ago, a Morton County jury directed Greenpeace to pay Energy Transfer about $667 million, finding the environmental group at fault for inciting illegal acts against the company during anti-pipeline protests in North Dakota in 2016 and 2017 and for publishing false statements that harmed Energy Transfer’s reputation.

Greenpeace denies Energy Transfer’s claims and maintains that it brought the lawsuit to hurt the environmental movement.

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Southwest Judicial District Judge James Gion in October slashed the jury’s award to $345 million, though he didn’t finalize the award until late February.

Greenpeace is now taking steps to fight the judgment, which includes its motion for a new trial.

The environmental group’s reasons for the request include claims that the jury instructions and verdict form contained errors, and that Energy Transfer was allowed to present unfair and irrelevant evidence to jurors. The group also alleges the jury pool was biased.

Greenpeace says the jury’s award assumes that Greenpeace was entirely responsible for any injury Energy Transfer sustained related to the protests. Jurors were not given the opportunity to consider whether Greenpeace was only at fault for a portion of the damages, the organization wrote in its brief.

Attorneys for Greenpeace also referenced the mailers and other media circulated to Mandan and Bismarck residents before the trial that contained anti-Dakota Access Pipeline protest and pro-energy industry content.

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The environmental group seeks a new trial in Cass County, arguing in part that the jury pool in the Fargo area would be more fair because its residents did not directly experience the Dakota Access Pipeline protests and because the local economy is less dependent on the energy industry.

If Greenpeace’s request for a new trial is denied, it plans to appeal the case to the North Dakota Supreme Court, the organization has said.

Greenpeace previously asked for the trial to be moved from Morton County to Cass County in early 2025, which Gion and the North Dakota Supreme Court denied.

The lawsuit is against three separate Greenpeace organizations — Greenpeace USA, Greenpeace International and Greenpeace Fund.

Energy Transfer as of Wednesday morning had not submitted a response to Greenpeace’s motion for a new trial. Previously, the company has defended the jury’s verdict and disputed Greenpeace’s claims that the court proceedings were not fair.

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Energy Transfer has indicated it may appeal Gion’s decision to reduce the award to $345 million.

Greenpeace will not have to pay any of the $345 million judgment for at least a couple of months, Gion ruled Tuesday.

Court documents indicate that the organization could have to pay a bond of up to $25 million while appeals proceed, though the environmental group has asked the judge to waive or reduce this amount. Gion has not decided on this motion.

He noted that obtaining such a large bond will be challenging.

“The magnitude of this matter defies simple decisions,” Gion wrote.

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Energy Transfer in court filings urged the judge to require Greenpeace to post the full $25 million.

Any bond money Greenpeace provides would be held by a third party while the appeals proceed, according to Greenpeace USA.

Greenpeace International has filed a separate lawsuit in the Netherlands that accuses Energy Transfer of weaponizing the U.S. legal system against the environmental group. Energy Transfer asked Gion to order that the overseas suit be paused while the North Dakota case is still active, which Gion denied. The company appealed his ruling to the North Dakota Supreme Court, which has yet to make a decision on the matter.



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