Risk Worth Taking? Inside North Dakota’s Move to Make ACA Plans Cover GLP-1s

Apr 10
Apr 10, 2025

Health insurers have largely resisted mandates to cover drugs for weight loss, notably opposing a now-scuttled rule that would have applied to Medicare Part D and Medicaid. But in North Dakota, the dominant Affordable Care Act exchange insurer ended up supporting the state’s effort to become the first to add GLP-1s that treat obesity to its essential health benefit (EHB) plan.

“We’re a pretty small health insurer by national standards…we’re a nonprofit mutual. So yeah, the financial risk was daunting,” Dan Conrad, president and CEO of Blue Cross Blue Shield of North Dakota, said during a webinar hosted by Modern Healthcare on March 30.
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Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.