Rural Challenges: Could State Insurance Benefit Help Recruit Rural Responders?

There are a number of challenges facing rural North Dakota. Over a series of upcoming posts on ND xPlains, I’d like to highlight some of those challenges including what may help mitigate some of the issues. Let’s start with a recent report showing the need for volunteer first responders in rural North Dakota. What are people willing to do? Should the state participate in incentivizing recruitment and retention though its health insurance plan?

North Dakota relies heavily on volunteers for responding to emergencies. It is the nature of living in a rural state. Smaller communities face a number of challenges in how to maintain these necessary services. It is a situation amplified by smaller populations to recruit from and fewer resources to fund operations.

Yet, emergency services are essential. It isn’t just those who call these smaller communities home that access these services. People traveling the state who find themselves in need of an emergency responder in a rural area also rely on those volunteer first responders. We expect someone to answer the call no matter where we are. To keep those rural responders viable, should the state step up with its greater pool of financial resources?


One of the common comments from rural organizers -whether it is ambulance service or fire department – is that it’s tough to recruit and retain volunteers because it is a lot of time commitment and often no pay. There is also a lot of risk that goes into this type of volunteerism. Risks that may impact volunteers physically, but also mentally. The healing of those risks and impacts could be covered under the state’s health insurance plan. Shouldn’t we prioritize taking care of those who take care of us? 

North Dakota’s state health insurance package is a top-line benefit in the state. Lawmakers are quick to come to the defense and aid of the benefit because as part-time lawmakers they also receive the fully-funded health insurance benefit. When Governor Doug Burgum proposed public employees paying in 5% of their premiums, we knew it wouldn’t pass the legislature because it is their benefit. I wrote about that during the debate. That fully taxpayer-funded health insurance policy is guaranteed for at least four years while they’re in elected office and continues until they retire or are defeated in election. If applicable, it covers their immediate family as well. Lawmakers don’t pay a dime.

That fully-funded benefit alone has incentivized people to run and serve the state in elected office. Could the same incentive get qualified candidates to serve as rural responders? Perhaps. The state has the resources. These communities alone do not. Emergency response is an essential government service.

This is just one idea. Certainly one that could be more defined through the legislative process to mitigate potential abuses. I originally threw it out on my KFGO radio show. You can listen to that conversation here.  I’m curious what incentives you’re willing to put forward? What are you willing to do?

Tyler Axness
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