relative to parent-taught driver education as an alternative to traditional driver education programs.

2026 Regular Session Introduced by Aidan Ankarberg and 2 co-sponsors

ND HB 1452 requires health plans to cover at least two FDA-approved anti-obesity drugs for chronic weight management, with notices to policyholders and a limited 2025–2027 window.

Inexpedient to Legislate: MA RC 178-155 02/05/2026 HJ 3 P. 59

Summary — North Dakota HB 1452 (Anti‑obesity Medication Coverage)

Status
- Introduced: November 21, 2024
- Sponsors: Representatives Nelson and Mitskog
- Legislative status (as provided): Second reading — failed to pass (yeas 11, nays 82)

Purpose
- Require minimum prescription drug coverage standards in certain health benefit plans to ensure access to anti‑obesity medications approved by the U.S. Food and Drug Administration (FDA) for chronic weight management, and to require a follow‑up report and legislative proposal from the Public Employees Retirement System (PERS). The provision is temporary, with a built‑in expiration.

Key provisions
1. Prescription drug coverage requirement
- The prescription drug component of health benefits coverage must include coverage of at least two FDA‑approved anti‑obesity medications that have an indication for chronic weight management in patients with obesity.
- Insurers may not impose coverage criteria for these medications that are more restrictive than the FDA‑approved indications.
- Coverage may be subject to usual cost‑sharing (deductible, copayment, coinsurance) or annual/maximum benefit limits, provided such cost‑sharing is consistent with other pharmaceutical coverage under the same plan.
2. Notice to policyholders
- Insurers must notify policyholders in writing about the coverage requirement. The notice must be prominently positioned in literature or correspondence and provided with annual information or any other mailing to policyholders.
3. PERS report and legislative follow‑up
- Under ND law (section 54‑03‑28), the Public Employees Retirement System must prepare and submit a bill to the Seventieth Legislative Assembly to: (a) repeal the Act’s expiration date and extend anti‑obesity drug coverage to all group and individual policies; and (b) append a report describing the effect of the requirement on PERS health programs, utilization and cost data, and a recommendation on continuation.
4. Application and expiration
- Applies to health benefits coverage that begins after June 30, 2025 and does not extend past June 30, 2027.
- The Act is effective through June 30, 2027, after which it becomes ineffective unless extended.

Who is affected
- Health insurers and administrators providing prescription drug benefits in North Dakota for policies beginning after June 30, 2025 (subject to the Act’s limited term).
- Covered individuals with obesity who seek FDA‑approved chronic weight‑management medications.
- The Public Employees Retirement System (required to report and propose continuation).

Potential impacts
- Increased access to FDA‑approved anti‑obesity drugs for covered members; potential upward pressure on prescription drug spending for insurers and plan sponsors depending on uptake and pricing.
- Administrative requirements for insurers (coverage policy updates, member notices).
- PERS will incur administrative work to compile utilization/cost data and prepare the recommended bill and accompanying report.

Effective timeline
- Coverage requirements apply to plans starting after 6/30/2025.
- The law would expire on 6/30/2027 unless legislative action extends or repeals the expiration as recommended by PERS.