North Dakota Insurance Commissioner Jon Godfread took his position just as the agency was being hit with budget cuts and cracks in the national health care insurance system began to show.

“At the end of the day, we did really well,” Godfread said of dealing with budget cuts of about 14.5 percent. 

The insurance department budget, House Bill 1010, was passed with about $10.9 million in 2017-19 funding as well as authorization for 46 staff, a decrease of 3.5 staff, which resulted in the shuffling of some duties, he said.

Godfread said his previous role as vice president of governmental affairs for the Greater North Dakota Chamber prepared him for his new position.

Now, he is watching the congressional Republican effort to replace the Patient Protection and Affordable Care Act, commonly referred to as Obamacare.

The House earlier this month passed the American Health Care Act. Senate Republicans are expected to craft a significantly different version of the bill, with ultimate passage through both chambers far from certain.

The Legislature used 77 of its permitted 80 days this session, leaving three days to address any major changes to health care insurance.

“I think there’s going to be a need at some point,” Godfread said. “We’re in the first period of a very long discussion.”

North Dakota has three providers in the health care marketplace, but Godfread has expressed concern that the ACA, as it exists, could collapse under its own weight. He said the state’s market seems to be solid for 2018 but providers could pull out, as has occurred in several other states.

Godfread said one key state legislative policy victory was the passage of Senate Bill 2231, which addresses air ambulance service concerns in which patients have been hit with large bills from out-of-network carriers.

SB2231 requires hospitals to inform patients or their representative prior to referring them to air ambulance services on their network status. The law also requires air ambulance services not participating in the network to charge the average rate of participating members.

“You’re literally a helicopter ride away from bankruptcy … due to no fault of your own,” Godfread said. “It’s an issue all across the country.”

He said the fix is within the state’s authority and should alleviate the problem.

(Reach Nick Smith at 701-250-8255 or 701-223-8482 or at