Health Care Decisions | Video

Jessica Roose | 9/6/2012

North Dakota lawmakers have their work cut out for them when it comes to implementing the Affordable Care Act. The main decision involves which health benefit plan the state will use as a benchmark, because all other plans will build from that. Legislators weighed their options at the Capitol today.

The apparent deadline for that decision is coming up on September 30, but like so many other aspects of implementing the law, even that is up in the air.

"For North Dakota what is a typical employer plan?"

That was one of many questions legislators discussed with the insurance commissioner and a group of panelists as they attempt to choose a health benefit plan for the state.

"What it really is, is the mandates. This becomes the floor that would have to be in every health insurance policy, what benefits are," said North Dakota Insurance Commissioner Adam Hamm.

The state can choose between ten benchmark plan options which vary in what they cover and how much they cost.

"I advocate and Sanford Health Plan advocates for a minimalistic approach to the benefits because we believe strongly that carriers will respond to the market and add benefits as our clients, our employer groups and individuals see fit and that they need and price them appropriately," said Sanford Health Director of Planning Lisa Carlson.

But Hamm says choosing the basic plan could cause disruption in the market.

"Small employers may terminate the previous richer plans, especially if the more basic plans cost less, clearly. This may leave employees with far fewer benefits then they previously had or without employer sponsored coverage."

He added that a potential positive to choosing the basic plan is that it could allow insurers to design competitive plans. Or the state could go the other route and choose a more extensive plan, which would likely cost more but would give more coverage to the insured.

It`s unclear as to who will make the final decision. The U.S. Department of Health and Human Services says it could be made by the state legislature or the insurance commissioner.

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