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

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.

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.

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.

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

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.

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.

Building international connections is an important aspect of the agricultural industry.

This year, farmer

Rudy Dotzenrod

hosted visitors from the Big Iron International Visitors Program to his farm to showcase his crops and Reinke irrigation systems.

“They were looking for a place to kind of showcase some of their swing-arm technology at the end of their pivots,” Dotzenrod said. “I’ve got a couple of them here, so they wanted to come.”

There were visitors from all of the world, including Turkey, Guatemala and Africa.

“We bring in anywhere from 50 to 150 international visitors every year,” said Lindsey Warner, deputy director of the North Dakota Trade Office. “The goal of that is, first and foremost, have agriculture machinery buyers learn more about North Dakota, our agriculture, our agriculture practices, the machinery that’s manufactured here.”

They got to see every part of the farming operation.

“I took a lot of them, and we walked around the farm, we went to different buildings and we looked at all sorts of different kinds of machinery, you know, from getting the ground ready, to planting, to spraying it, to harvesting it, just kind of looked at everything,” Dotzenrod said.

With Dotzenrod also being a black bean grower, that was beneficial to the visitors from Guatemala.

“They were very interested in irrigation and black beans,” Warner said.

However, most were interested in his corn production.

“I was kind of surprised, I thought there may be a few more questions on edible beans, but it was mostly in corn,” Dotzenrod said.

Bringing international visitors directly onto the farm is a big part of the tour.

“We live in a global world. A lot of the commodities that are produced within our state are exported outside of the U.S., so I think it’s really beneficial for people to see where their food is coming from, whether they are North Dakotas or they are international consumers of these products” Warner said.

“People kind of want to know where their food is coming from, you know, and if they can try and put a face on that or an environment, that gives them a better understanding of where it’s at,” Dotzenrod said. “A lot of this is beyond the economics of it. It’s relationship based. If they feel like they’re buying something from somebody they like, I think it makes it a lot easier for them to go ahead and do that.”

FARGO — A bill has been introduced at the North Dakota Legislature requiring a new addition to every public classroom in the state: the Ten Commandments.

House Bill 1145 is proposing the display of the Ten Commandments in every public school classroom and every higher education classroom. That goes for all state educational institutions and public schools.

Ultimately, what’s being proposed is that the text of the Ten Commandments would be placed in every classroom, but some are worried about the message that would send to students and their families.

Those behind the bill claim North Dakota’s Constitution was based on values that derive from the Ten Commandments.

“It just seemed not only important and necessary, and it just kind of dovetailed into being able to put the Ten Commandments back into the public square,” Sen. Jose Castaneda, R-Minot, said.

And while North Dakota’s newest legislative session just got underway, the topic is not new to the state.

A similar discussion took place in 2021 in North Dakota, passing through the state House and Senate, but that bill didn’t require the text be posted. And the Ten Commandments monument in Fargo has long stirred controversy.

Castaneda argues placing the text of the Ten Commandments in every classroom will instill North Dakota’s values in children.

“It’s important for everyone to be able to see them, and where do children spend their time? It’s in the classrooms,” he said.

The commandments would need to be displayed on an 11-by-14 inch poster, and the state Board of Higher Education would be allowed to spend money to purchase the displays.

“To get a high degree of something, there needs to be a lot of repetition, and where children receive that on a daily basis — in the classroom,” Castaneda said.

But some are worried about whether the bill violates the separation of church and state section of the U.S. Constitution.

“Public schools are not Sunday schools, and they are not for religious instruction,” Cody Schuler, the North Dakota advocacy manager with the ACLU, said.

Those against the proposal say the words of the U.S. Constitution should matter in this discussion.

“Really, by the state putting into law mandating one particular version of a religious document, it is showing preference, and that would be a violation, in our opinion, of the separation of church and state,” Schuler says.

The bill has yet to be assigned to a committee.

A bill with similar language was passed last summer in Louisiana before being struck down by a federal judge.

A lawmaker in South Dakota is also proposing the Ten Commandments be posted and taught in public schools.

Isak Dinesen joined WDAY-TV as a reporter in September 2024. He previously worked as a multimedia journalist at WAOW-TV in Wausau, Wisconsin for three years. He graduated from NDSU in 2020, majoring in Journalism and minoring in Sports Communication at MSUM.