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Lawmakers send Medicaid expansion to governor

BISMARCK -- An estimated 20,500 North Dakotans will receive health insurance once Gov. Jack Dalrymple signs a bill passed Tuesday.

Senate lawmakers voted 33-14 to pass House Bill 1362, which expands Medicaid coverage under the Patient Protection and Affordable Care Act, often called Obamacare, passed by Congress in 2010. The act provides insurance for individuals 19 to 65 who are not disabled, don't have insurance and have an income less than 138 percent of the federal poverty level.

Those living under 138 percent of the federal poverty level in North Dakota include an individual earning $1,285 a month, according to the Department of Human Services.

If signed into law, the expansion will become effective Jan. 1 and end July 31, 2017, when federal match payments drop from 100 percent to 95 percent.

The state expects between $154 million and $171 million in federal funds to come in during the next biennium to pay for the program.

The state's share to cover the expansion for the current biennium will be about $248,789 from the general fund and about $2.8 million to $3.1 million for the 2015-17 biennium. The costs are associated with an increase in administrative oversight.

Dalrymple has included money for expanded Medicaid in his budget proposal.

Supporters of the expansion argue that North Dakotans already are paying taxes to support the program, and, without it, individuals with insurance must absorb the medical costs for the uninsured.

"With the passage of the bill, it will finally be a good day for a new group of citizens who are becoming participants in our positive health care system," said Sen. Tim Mathern, D-Fargo.

Opponents said the state shouldn't rely on the federal government for the funding since it's almost $17 trillion in debt and it's not the government's position to get involved.

"The money will have to be repaid by our children and grandchildren. It's immoral to grant benefits today that can't be sustained and must be repaid by future generations," said Sen. Margaret Sitte, R-Bismarck. "It's not free money from the federal government, it's our money, the hard earned money from middle Americans who are struggling to make ends meet and pay their taxes each week."