Medicaid changes may bring challenges, but North Dakota seen as prepared

North Dakota officials say the state is well-positioned to adapt to proposed Medicaid changes under President Donald Trump’s “One Big Beautiful Bill,” which passed the House on May 22 by a 215-214 vote. But the bill includes new work and eligibility requirements that could add bureaucratic burdens and cause some residents to lose coverage, according to reporting by the North Dakota News Cooperative. According to Rep. Julie Fedorchak, R-N.D., the state may hold a special session to approve more Medicaid eligibility staff and budget changes.

Only about 10% of North Dakota’s Medicaid recipients fall into the category affected by the work rule, and enrolled tribal members are exempt. Sioux, Rolette and Benson counties — home to Standing Rock, Turtle Mountain and Spirit Lake reservations — have the state’s highest Medicaid enrollment rates. The bill still requires Senate approval before becoming law.