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North Dakota

According to a report from Kaiser Family Foundation (KFF), about 54,000 people did not have health insurance in North Dakota as of 2019. That represents 7.4% of the state’s population. When KFF looked at the uninsured rate again in 2021, they found that about 32,000 could qualify for marketplace health insurance.

Marketplace health insurance is the kind that’s sold on the marketplaces created under the Affordable Care Act (ACA). But “marketplace” can also be shorthand for comprehensive coverage, the kind that the ACA regulates. These plans cover pre-existing conditions as well as 10 essential health benefits.

The ACA also created premium tax credits, also known as subsidies, to help people with low to moderate incomes afford health insurance. Available to people earning between 100% and 400% of the federal poverty level, these subsidies lower the cost of premiums. Most people qualify for a subsidy.

In fact, when KFF looked at the uninsured rate in North Dakota for 2021, they estimated that around 31% of the people who don’t have coverage but who qualify for marketplace plans could get a bronze plan for free — i.e., no premium at all.

The nonprofit also analyzed premium data overall and found that the average lowest monthly premium for a bronze plan in North Dakota in 2021 is $273. The average low for silver is $464 a month and the average lowest priced gold plan is $432 a month. Note that the gold plan average is slightly lower than the average for silver plans.

These amounts don’t include tax credits. If you qualify for a subsidy, you may save money on your premiums each month.

We looked at health insurance premiums in North Dakota using our own marketplace. A 40-year-old living in Fargo with an annual income of $37,000 a year could find a bronze plan for just under $95 a month. That does include premium subsidies to lower the cost.

Plan options and cost depend on where you live. There are at least three insurers offering marketplace health plans in North Dakota in 2021, including Medica, BlueCross BlueShield of North Dakota, and Sanford.

Sources

Kaiser Family Foundation, “Health Insurance Coverage of the Total Population”
Kaiser Family Foundation, “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach” (January 27, 2021)
Kaiser Family Foundation, “Average Marketplace Premiums by Metal Tier, 2018-2021”
Kaiser Family Foundation, “Insurer Participation on the ACA Marketplaces, 2014-2021” (November 23, 2020)

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