North Dakota

North Dakota: From Broad Domestic Agenda to Singular Federal Health Care Focus

Governor Kelly Armstrong's two addresses to the North Dakota Legislature represent a dramatic shift in scope and ambition. His 2025 State of the State was a comprehensive policy address covering property tax reform, behavioral health, energy infrastructure, education choice, government efficiency, and more. His 2026 address, by contrast, was delivered at a special session with a deliberately narrow focus: the appropriation and deployment of $199 million in federal funds awarded through the Rural Health Transformation Program via the Centers for Medicare and Medicaid Services (CMS).

The 2025 address centered on Armstrong's signature initiative — an aggressive property tax relief and reform plan aimed at putting the majority of primary residences on a path to zero property taxes within a decade. The plan combined an increase in the Primary Residence Credit from $500 to $1,000 (costing ~$310 million for the biennium), a dedicated Legacy Fund earnings stream of $173 million for additional credits of $550 per residence, and a 3% annual cap on local property tax budget increases. Armstrong framed this as the most important thing the Legislature could do that session. None of this was mentioned in 2026, as the special session was explicitly scoped to a single purpose.

The 2026 address is entirely devoted to rural health care transformation, built on four pillars: wellness promotion (branded as "Make North Dakota Healthy Again"), rural health workforce stabilization, expanded local access through telehealth and mobile clinics, and health care technology and data modernization. Armstrong emphasized that nearly 75% of North Dakota's rural counties face primary care shortages and that health care had concentrated in the largest communities over two decades. He projected the state could receive at least $500 million over five years, and potentially close to a billion, if the funds were deployed effectively. He was also careful to stress fiscal restraint — no new buildings, no unsustainable programs, and no new state-funded employee obligations.

The shift between the two years is best understood not as a change in governing philosophy, but as a reflection of the different legislative contexts — a regular session in 2025 versus a special session in 2026 called specifically to address the federal health care funding opportunity. Armstrong's 2025 priorities like education savings accounts, charter schools, energy pipeline infrastructure, and criminal justice reform were not abandoned but simply outside the scope of the 2026 special session. The through-line between both speeches is Armstrong's closing vision of making North Dakota "the best place to live, work and raise a family."