In 2022, Medicare transfers in North Dakota totaled $1.82 billion, amounting to $2,340 per capita, or 23.6% of total government transfers in the state, according to information from the Economic Innovation Group.
Among all government transfer programs, Medicare was the second largest contributor. Social Security was the largest, totaling $2.62 billion, equating to $3,356 per capita and making up 33.9% of total transfers.
Medicaid was the third largest contributor in North Dakota in 2022, accounting for $1.59 billion, averaging $2,036 per capita, and represented 20.5% of transfers in the state. Income Maintenance transfers provided another $599.7 million, averaging $770 per capita and comprising 7.8% of government support, making them the smallest contributors.
Statewide, including all transfer types, government transfer payments totaled $7.72 billion, and accounted for 14.1% of residents’ total income, with an average of $9,913 per resident.
Government transfer payments are non-repayable funds provided by federal, state, or local governments to support individuals in need. These payments aim to stabilize economic conditions and provide financial support during hardships. Key programs include Social Security transfers (retirement benefits), Medicare transfers (healthcare for seniors), Medicaid transfers (healthcare for low-income individuals), and income maintenance transfers (financial assistance for basic needs).
With 16.6% of the population aged 65 and older, North Dakota has a significant demand for programs like Social Security and Medicare. The total per capita income in North Dakota, excluding government transfers was $60,446.6, which is below the county’s total income of $70,360, emphasizing the role of government transfers in overall income.
When comparing 2022 to the previous year, North Dakota saw no change in its Medicare transfer dependency.
Government transfers have long been a modest financial safety net, historically comprising only a small fraction of Americans’ income. However, since the 1970s—sometimes dubbed the “Great Transfer-mation”—dependency has surged from 8.2% (or $2,022 per capita in inflation-adjusted 2022 dollars) in 1970 to 17.6% (or $11,542 per capita) in 2022 nationwide. In North Dakota, reliance on government transfers has similarly increased from 9.4% (or $1,876 per capita) in 1970 to 14.1% (or $9,913 per capita) in 2022.
According to the Economic Innovation Group’s analysis, these trends are not merely short-term responses to economic pressures but rather reflect a profound, long-term transformation in how government support is integrated into American life. The study illustrates that structural shifts—from rising healthcare expenses and demographic changes to stagnant wages—have significantly increased dependency on government transfers.
| County | Rank | Dependency on Transfers (%) | % Population 65+ | Social Security Transfers (%) | Medicare Transfers (%) | Medicaid Transfers (%) | Income Maintenance Transfers (%) | Per Capita Transfers ($) |
|---|---|---|---|---|---|---|---|---|
| Cass County | 1 | 10.8% | 12.9% | 4% | 2.5% | 1.6% | 0.9% | $7,444 |
| Burleigh County | 2 | 13.4% | 17.9% | 5.1% | 3.3% | 2.4% | 0.8% | $9,577 |
| Grand Forks County | 3 | 14.7% | 14.4% | 4.9% | 3.5% | 2.6% | 1.2% | $8,964 |
| Ward County | 4 | 14.6% | 14.3% | 4.5% | 3.3% | 2.7% | 1.2% | $9,145 |
| Morton County | 5 | 16.4% | 17.3% | 5.7% | 4% | 3.2% | 1.2% | $9,956 |
| Stark County | 6 | 12.6% | 14% | 4.2% | 2.8% | 2.7% | 1% | $8,426 |
| Stutsman County | 7 | 18.2% | 20.5% | 6.2% | 4.1% | 4.6% | 1.2% | $12,343 |
| Williams County | 8 | 9.4% | 10.6% | 3.1% | 2.1% | 1.9% | 0.9% | $6,490 |
| Rolette County | 9 | 33.5% | 13.2% | 5.6% | 5.2% | 12.8% | 5.8% | $19,076 |
| Richland County | 10 | 16.4% | 20.4% | 6.1% | 3.8% | 3.1% | 1.1% | $10,843 |
| Ramsey County | 11 | 20.4% | 21.4% | 6.3% | 4.6% | 5.5% | 1.5% | $13,907 |
| Walsh County | 12 | 19.6% | 22.2% | 6.1% | 5.8% | 4.5% | 1.3% | $14,881 |
| Barnes County | 13 | 17.8% | 23.4% | 6% | 4.1% | 4.3% | 1.1% | $13,491 |
| McLean County | 14 | 17% | 26.3% | 6.2% | 4.2% | 3.6% | 0.8% | $13,771 |
| Mercer County | 15 | 19.3% | 22.6% | 7.7% | 5.6% | 3.3% | 0.9% | $12,778 |
| Traill County | 16 | 17.3% | 20.5% | 5.6% | 4.2% | 4.1% | 1% | $13,043 |
| Mountrail County | 17 | 12.8% | 13.7% | 3.6% | 2.6% | 3.7% | 1.1% | $10,398 |
| Bottineau County | 18 | 16.2% | 25.3% | 5.5% | 4% | 3.6% | 1.1% | $14,564 |
| Benson County | 19 | 22.9% | 16% | 4.9% | 4% | 7.6% | 3.4% | $15,683 |
| Pembina County | 20 | 15.2% | 25.7% | 5.9% | 4.3% | 2.6% | 0.8% | $13,336 |
| Ransom County | 21 | 18.9% | 22% | 5.5% | 4.4% | 5.4% | 0.9% | $14,042 |
| McKenzie County | 22 | 7.3% | 10.3% | 2.2% | 1.6% | 1.5% | 0.8% | $5,568 |
| Dickey County | 23 | 15.9% | 20.1% | 4.5% | 3.6% | 5.1% | 1% | $14,804 |
| McHenry County | 24 | 17.7% | 21.9% | 5.5% | 4.6% | 3.3% | 1.3% | $13,835 |
| Wells County | 25 | 15.1% | 28.3% | 4.6% | 3.7% | 4.1% | 0.9% | $16,511 |
| Pierce County | 26 | 20.2% | 24% | 6.2% | 4.6% | 5.4% | 1.5% | $15,101 |
| Nelson County | 27 | 20.7% | 27.6% | 6.4% | 4.3% | 6.9% | 0.9% | $19,084 |
| Sioux County | 28 | 38.7% | 9.3% | 4.8% | 4.5% | 17.3% | 7.3% | $14,991 |
| Cavalier County | 29 | 10.7% | 27.9% | 4% | 2.9% | 2.4% | 0.6% | $14,531 |
| LaMoure County | 30 | 13.5% | 27.6% | 4.8% | 3.7% | 2.4% | 0.9% | $12,749 |
| McIntosh County | 31 | 23.5% | 30% | 6% | 6.6% | 7.8% | 1.1% | $21,094 |
| Emmons County | 32 | 16.3% | 28.6% | 5.4% | 4.8% | 3.2% | 1% | $15,293 |
| Sargent County | 33 | 13% | 23.1% | 5.1% | 4.1% | 1.5% | 0.7% | $12,105 |
| Dunn County | 34 | 11.4% | 18.9% | 3.6% | 2.8% | 2.6% | 0.7% | $10,467 |
| Bowman County | 35 | 18.7% | 24.3% | 6.1% | 6.5% | 3.7% | 0.8% | $14,020 |
| Foster County | 36 | 12.8% | 23.7% | 4.5% | 3.3% | 2.5% | 0.8% | $11,693 |
| Griggs County | 37 | 16.7% | 31.3% | 5.7% | 4.3% | 4.4% | 1.1% | $15,703 |
| Eddy County | 38 | 16.8% | 22.2% | 5.3% | 2.9% | 6.1% | 1% | $15,169 |
| Kidder County | 39 | 17.5% | 27.5% | 5.2% | 3.9% | 4.7% | 1.1% | $14,601 |
| Towner County | 40 | 14% | 27.4% | 4.5% | 3.5% | 3.7% | 0.9% | $16,773 |
| Adams County | 41 | 27.7% | 30.5% | 9.1% | 7.7% | 7% | 1.5% | $16,267 |
| Grant County | 42 | 23.3% | 30.9% | 7% | 6.9% | 4.7% | 2% | $14,996 |
| Renville County | 43 | 13.3% | 20.9% | 4.1% | 2.8% | 4% | 0.7% | $15,048 |
| Hettinger County | 44 | 19.6% | 23% | 6.7% | 5% | 4.8% | 1.3% | $13,197 |
| Divide County | 45 | 18.4% | 25.3% | 5.7% | 5.5% | 3.9% | 1.1% | $13,583 |
| Logan County | 46 | 18.2% | 26.7% | 4.9% | 4.3% | 5.5% | 1.1% | $15,539 |
| Burke County | 47 | 9.4% | 22.5% | 3.9% | 2.7% | 1.4% | 0.6% | $9,690 |
| Steele County | 48 | 9.4% | 25.8% | 4.6% | 2.7% | 0.4% | 0.7% | $10,899 |
| Sheridan County | 49 | 15.2% | 35.9% | 5.4% | 3.6% | 2.9% | 1.5% | $15,039 |
| Oliver County | 50 | 15.2% | 25.2% | 7.8% | 3.6% | 1.1% | 1.1% | $9,563 |
| Golden Valley County | 51 | 17.4% | 27.6% | 7.5% | 5.6% | 1.5% | 1.1% | $9,894 |
| Slope County | 52 | 17.8% | 30.8% | 6.9% | 3.3% | 3% | 1.5% | $10,190 |
| Billings County | 53 | 6.8% | 23.9% | 3.5% | 1% | 0.8% | 0.7% | $5,653 |
