Courage in Action: Cancer Survivors Unite at State Capitol to Advocate for Change
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Shawn ONeal
Senior Regional Media Advocacy Manager
Big Wins Against Cancer: Advocates Celebrate Successful 2025 North Dakota Session, Await Signature on Co-Pay Accumulators
Prior Authorization Reform and Prescription Cost Relief Legislation Will Ease Medical Stress for Cancer Patients, Many Others
April 21, 2025
BISMARCK, ND -– North Dakota legislators made strong moves against cancer this session, passing bills on prior authorization reform and co-pay accumulator adjustments. The last of those bills – House Bill 1216 – passed the ND Senate on Monday and awaits Gov. Kelly Armstrong’s signature.
Advocates of the American Cancer Society Cancer Action Network are grateful for lawmakers’ willingness to listen to the patients and survivors who regularly visited Bismarck this session, sharing their experiences and concerns and asking for these new laws be enacted to ease the burden of cancer for all North Dakotans.
“For the work of our advocates to make such a difference and for lawmakers to understand the significant need for these changes and take such decisive action has made for a great session,” ACS CAN North Dakota Government Relations Director Ben Hanson said. “To get one of these done would have been progress, but what this session did was mark a major step forward for folks who need it most.”
The legislation is as follows:
Co-pay accumulators: Sponsored by Rep. Karen Karls of Bismarck, House Bill 1216 requires all prescription drug copayments made by patients, directly or on their behalf, to count toward their overall out-of-pocket maximum or deductible, making cancer treatment more affordable and saving some North Dakotans from additional medical debt. A 2022 ACS CAN study found 31% of cancer patients and providers noted paying for prescriptions as a challenge and 20% indicated that financial considerations had caused them to skip or delay taking prescribed medication.
“We need insurers to count copay assistance paid by or on behalf of an enrollee toward their annual deductibles and out-of-pocket limit to allow North Dakotas life-saving drugs,” Karls said. “This bill would be a step toward easing that problem.”
Prior authorization reform: For the more than 4,500 North Dakotans who will be diagnosed with cancer in 2025, medical prior authorization can delay treatment, increase stress and have a negative impact on care. Senate Bill 2280 establishes standards and transparency to prior authorization processes, helping those in need of critical medical care avoid prolonged delays in treatment.
Physicians report the process can lead to significant delays in care, contributing to negative outcomes in patients, including abandoned treatment. The process was once used sparingly by insurers to determine whether costly medical procedures or medications were needed but has devolved into a system requiring providers get approval to prescribe even the most routine medications and procedures. The bill’s primary sponsor was Sen. Scott Meyer (Grand Forks) with Sens. Jeff Barta (Grand Forks), Brad Bekkedahl (Williston) and Sean Cleary (Bismarck) co-sponsoring in the Senate and Reps. Jonathan Warrey (Casselton) and Jon Nelson (Rugby) in the House.
ACS CAN encourages individuals, businesses and organizations that are interested in getting involved in the year-round fight against cancer to visit https://www.fightcancer.org/states/north-dakota.
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