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  • Writer's pictureDakotans for Health (Policy)

FORMER NORTH DAKOTA OFFICIALS warn of Supreme Court threat to North Dakota health care

Updated: May 18, 2021

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North Dakota Edition

How repealing the ACA will impact North Dakota

Former Deputy Secretary Mary Wakefield and Former Congressman Earl Pomeroy
Former Deputy Secretary Mary Wakefield and Former Congressman Earl Pomeroy


Grand Forks, North Dakota - Because of its far-reaching adverse impact on North Dakota, former Congressman Earl Pomeroy and Deputy Secretary for U.S. Health and Human Services Mary Wakefield call on Attorney General Wayne Stenehjem to end North Dakota’s push to have the Affordable Care Act (ACA) thrown out.


Congressman Pomeroy and Secretary Mary Wakefield were joined members of the media and healthcare community to discuss the case, and its' potential consequences. You can find audio filed below of including introductory statements from Congressman Pomeroy and Secretary Wakefield.


Former Congressman Pomeroy and former Deputy Secretary of Health and Human Services Mary Wakefield discussed the serious consequences for public health and affordable insurance coverage in the state if North Dakota’s lawsuit against the Affordable Care Act is successful. The case will be argued within a week of the Presidential election.


The decision by the North Dakota Attorney General to have the state join a lawsuit in Texas to overturn the Affordable Care Act (ACA), could cause severe negative consequences for North Dakotans. If the lawsuit succeeds with the new makeup on the Supreme Court, it will not only repeal protections for pre-existing conditions for North Dakotans trying to obtain insurance coverage, it will result in at least 23,000 North Dakotans losing their health insurance currently covered under Medicaid Expansion. It will also end the protection for adult children up to age 26 to remain on their family’s coverage. Our hospitals, dealing with the exceptional patient loads caused by the COVID pandemic, will also be impacted.

Pomeroy Remarks and Audio Files

North Dakota Congressman Earl Pomeroy discusses the Affordable Care Act
Former North Dakota Congressman and Insurance Commissioner Earl Pomeroy

You can DOWNLOAD Congressman Pomeroy's FULL REMARKS ➔HERE

“Why would anyone work so hard to strip insurance away from people right in the middle of this COVID virus crisis?” Pomeroy asked. “This is potentially devastating to families as well as to the health care system facing the prospect of dealing with very sick people who have suddenly lost their insurance,” he said. “North Dakota should never have filed this lawsuit in the first place, but dropping it now will make an important statement that times have changed and the health coverage protections North Dakotans have should not be taken away. Losing these vital health insurance protections in the in the middle of the pandemic does not make sense.”, said Earl Pomeroy.

Wakefield Remarks and Audio Files

Mary Wakefield and Barack Obama discuss the Affordable Care Act at the White House
Deputy HHS Secretary Mary Wakefield and President Barack Obama

You can DOWNLOAD Secretary Wakefields FULL REMARKS ➔HERE

“Given the threat of COVID-19 to the health and well-being of North Dakota families, government officials should be protecting access to health care in every way possible, not tearing it apart. This is especially important to the higher proportion of people in rural communities who live with chronic illnesses. To make matters worse, over 70% of the hospitals that have closed across the country over the past few years closed in states that did not expand Medicaid. If the ACA is thrown out, many of North Dakota’s hospitals will experience financial consequences heaped on top of the adverse impact the pandemic is having.’ ”, said former Deputy Health and Human Services Secretary Mary Wakefield.


The lawsuit is brought by the Texas state Attorney General and will be argued in the Supreme Court as Texas vs US, the third time the Supreme Court will consider throwing out the landmark health law. Two or potentially three new justices will be on the Court when it hears this challenge, placing the outcome very much in doubt. Many believe this is the weakest legal case but the most serious challenge in light of the highly political nature of the lawsuit.

The impact of the lawsuit will result in many North Dakotans losing their health insurance and ability to pay for the care that they need. The lawsuit comes at a tough time for North Dakota agriculture as many local farms and businesses struggle to cope with declining revenues due to the Coronavirus disease.

Attorney General Wayne Stenehjem filed the lawsuit Texas, et al. vs. United States, et al. to overturn the entire Affordable Care Act (ACA), including its protections for North Dakotans and others with pre-existing conditions. If the Supreme Court rules in favor of Stenehjem, here is a list of some of what will be eliminated:

For North Dakota Public Health and Healthcare

  • The Public Health and Prevention Fund (PHPF) which supports ND programs that address common health problems in the state like diabetes and heart disease. PHPF helps to meet priority health needs and strengthen important public health capacity.  ND received over $2.8 million in 2019 from PHPF. Receiving money annually since the ACA was enacted (2010- 2019), ND has benefited from over $25 million from this Fund. The PHPF would be repealed.

  • North Dakota’s rural hospitals will lose between $10 and $20 million from a drug discount program (called 340B), the money from which is typically reinvested in larger community health services. This program for small hospitals would be repealed.

  • North Dakota’s rural hospitals will lose about $25 million per year with the elimination of Medicaid Expansion. Prior to the ACA, only 22 % of ND Critical Access Hospitals had positive operating margins. By 2019, 50% had positive operating margins. These losses can directly jeopardize rural health care providers and services for communities as thousands of North Dakota young and older adults seek health services without health insurance.

  • With thousands fewer North Dakotans with insurance coverage, ND health care providers will shoulder a $69 million burden associated with providing significantly more care that is uncompensated.

For North Dakota Families and Communities

  • Insurance companies would be able to deny coverage for people with pre-existing conditions seeking to buy health insurance. This protection is important to all who have or develop health conditions which could bar their ability to get coverage in the future.

  • Provisions that lower prescription drug costs for Medicare enrollees would be repealed resulting in over 3000 ND enrollees paying 100% of the Medicare coverage gap ($5,184 for 2021).

  • Provisions that allow about 7,500 young North Dakotans to stay on their parents’ insurance until age 26 would be repealed.

  • Insurance companies can once again impose annual and lifetime limits on the medical claims they will cover.

  • Financial assistance that middle income and low income individuals receive to help them buying health insurance coverage on the exchange will be eliminated. At a time when ND farmers, rural workers and recently unemployed need it most, this will end the ability of over 23,000 North Dakotans to continue to obtain this comprehensive health coverage and the option for others who would qualify in the future will be eliminated.

  • It would repeal Medicaid expansion, which currently covers health services for over 22,700 North Dakotans and brings over $180,000,0000 additional federal dollars back to the state each year. The economic impact of Medicaid Expansion to ND has been estimated at over $542 million. This expansion was put in place by Republican Governor Dalrymple and was a bipartisan effort of the ND state legislature.



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