There is nothing in the new healthcare bills that are good for North Dakota. Nothing.

Last week, the Senate revealed its Better Care Reconciliation Act (BCRA) of 2017. The bill was in response to the American Health Care Act (AHCA) passed by the House. Neither bill is good for North Dakota citizens. Neither bill is good for North Dakota hospitals.

When Congress passed the Affordable Care Act (ACA), also known as Obamacare, in 2008 it was flawed. But, because of ACA and Medicaid expansion, 20,000 more North Dakotans have access to healthcare coverage.

Both bills from the Senate and House would eliminate Medicaid expansion to those 20,000 people. This is a mistake.


When patients have health insurance, their behaviors change. Patients with health insurance go to the doctor more regularly for preventative care. That means they take care of a health issue early, rather than waiting until they require treatment. Those treatments can be more intense and expensive. Many times, people without insurance wait to receive care until they end up in an emergency department. Once there, they can’t afford their medical bills. That means the hospital absorbs that expense. No hospital – or any business – can do that in perpetuity.

The ACA expanded coverage for people in North Dakota and around the country. The newly insured people could now address their health problems before they turned into a medical crisis. The ACA kept people healthy and saved dollars for both hospitals and taxpayers.

If enacted, repealing Medicaid expansion will result in a loss of more than $1.5 million a year at Jamestown Regional Medical Center alone. Losing that revenue impacts JRMC’s ability to provide the services this community wants and needs. It also means that all who need healthcare are impacted. Not just those on Medicaid, but those with Medicare and private insurance too.

And, JRMC is not alone.

Repealing Medicaid expansion will destabilize hospitals all across North Dakota.

The current healthcare law, the ACA, is not perfect. It still needs to be fixed. However, the Senate has an opportunity to improve healthcare without eliminating Medicaid expansion. It is a hope that our Senators can provide leadership that focuses on repairs and improvements of the current law. Rather than repealing and eliminating health coverage for many in North Dakota and across the country.

This article was written by K.C. DeBoer, Jamestown Regional Medical Center President & CEO.