Page 2

2

There have been situations since Oct. 1, 2023 (date we implemented the 2023 Senate Bill No. 2181) where we were able to provide coverage for a pregnant woman who did not meet the 5-year waiting period or have enough qualifying quarter of social security coverage but had to deny her children coverage due to the current law. Passing this bill would ensure the family unit is eligible for Medicaid and children aren’t left without coverage we are able to grant to their pregnant mother.

There have also been a few situations in our state where a human service zone or the Division of Juvenile Services had custody of a child who was legally present in ND, however due to the five year, forty-quarter ban, the child did not qualify for Medicaid and their services had to be funded with state general funds.

Fortunately, there are not many children who fall into this category, but for those who do, their care is typically costly, as it may involve inpatient and residential levels of care. For example, the monthly cost for a child to receive treatment at a psychiatric residential treatment facility is around $19,000. Without the passage of this bill, the state will incur general fund expenses of around $236,877 in the 2025-27 biennium. This factor has been included in the fiscal estimate of the bill. By passing the bill, we can obtain federal matching dollars for all the children who fall into this situation, regardless of if their custody is transferred to a zone or the Division of Juvenile Services.

The fiscal impact of Section 1 for the 2025-27 biennium is $356,491 in general funds and $604,829 in federal funds.