MINOT, N.D. — Sanford is an acquisitive health care giant that is seemingly out to own every hospital in our region . Sanford also offers health insurance, and has begun offering plans, at a discount, which lock you into only using Sanford medical services.
You can choose non-Sanford care, but your Sanford-issued insurance policy won't cover it. Some are defending this, pointing out that the Sanford-only plans are cheaper, and save businesses money, but Americans live with a health care system that is broken in no small part because of how few choices they can make about their care.
Do we believe that giving them fewer choices is going to fix anything?
Before the Legislature in Bismarck is House Bill 1416 , introduced by Rep. Dwight Kiefert, which would prevent vertically integrated health insurance/health care companies such as Sanford from freezing out independent care providers. The independents would still have be within the geographical region where the insurance plan is offered, and they'd have to be "willing and fully qualified to meet the terms and conditions of participation, as established by the health insurer."
It's reasonable legislation aimed at protecting individual North Dakotans who need this protection because most of them, including your humble correspondent, are not the customers for their health insurance policies. Our employers pick them. And while an employer might like the discount which goes along with a policy that only covers care from Sanford, that's not such a good deal for the insured.
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If it seems like the bill is targeting Sanford, it is, but only because Sanford is the only vertically integrated HMO in the state. If others emerge, this legislation would protect them from price-pressuring North Dakotans into a walled garden of health care choices.
HB 1416 sailed through the House with an 84-9 vote, and it seems poised to do well in the Senate, too, having been passed out of the Human Services Committee with a 4-2 "do pass" recommendation on March 28.
But then something weird happened. On March 29, Sen. Kristin Roers, a Fargo Republican who, it's worth noting, is a Sanford employee, moved to reconsider the bill in committee.
Then Sen. Kathy Hogan, a Democrat, offered an amendment to the bill, which changed its effective date to Dec. 31, 2024.
Per the state constitution, bills passed during the legislative session become law on Aug. 1, just months after the session concludes, unless lawmakers put in a different effective date. With this amendment, HB 1416 would take effect more than a year after the legislative session concludes.
Why the change?
During the brief committee discussion, Sen. Judy Lee, a Fargo Republican and chair of the committee, said that the amendment was made at the behest of Levi Andrist, a registered lobbyist for Sanford, who said that a more immediate effective date would be unworkable because of the company having plans "in the hopper" or something.
Sen. Roers seconded Hogan's motion for amendment, and it passed.
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So, if you're keeping score at home, a Sanford lobbyist asked for a change in the bill.
A Sanford employee moved to have the committee reconsider this bill.
Sen. Hogan, who received a $500 campaign contribution from the Health Policy Consortium , a political action committee formed and chaired by a Sanford employee, then moved to add the Sanford lobbyist's amendment, with the Sanford employee seconding.
Now the amended bill again has a 4-2 "do pass" recommendation from the committee ( if you watch the video, you can hear Sen. Roers with an emphatic "no" when the roll call was called).
Did I mention that Sen. Lee, the committee chair, also received a $500 contribution from the Sanford-backed political action committee? Though, to be fair, Sen. Lee voted for the "do pass" recommendation, as did Sen. Hogan, and Lee will be carrying it to the floor. But still, what an illustration of the deep connections Sanford has to our Legislature.
I can't figure out what the purpose of pushing out the effective date is. I made an inquiry to Sen. Hogan for an explanation, but she didn't respond.
When this issue arose in South Dakota a few years ago, it was fodder for ballot measures . Could Sanford want to push back the effective date of this policy so they can bankroll a ballot measure? Or are the hedging their bets, hoping that is this bill passes this Legislature, they can delay it until the end of next year, just before another Legislature convenes?
I don't know.
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This bill did pass the House, by a wide margin, and seems likely to pass the Senate, which is perhaps why Sanford leaned on this committee to stretch out the timeline for implementation, but still. C'mon. The handoff on this amendment from Sanford lobbyist to Sanford employee to Sanford-backed politicians kind of stinks, even if at least some of the players support the overall bill.
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