The House passes bill to repeal the Affordable Care Act

What's the issue?

On May 4, the House of Representatives passed the American Health Care Act (AHCA) with a vote of 217-213.

As noted in the April issue of the Advocacy Brief, Speaker of the House Paul Ryan previously removed the bill from consideration because he did not have the votes to ensure its passage. Two amendments added to the bill secured the necessary votes.

The amendment proposed by Rep. Tom MacArthur (R-NJ) allows states to remove key provisions of the Affordable Care Act. Under the amendment, states could seek a waiver that would allow them to opt out of covering essential health benefits, like pediatric dental care. It would also allow insurance carriers to charge higher premiums for individuals based on their health status. In order for states to receive this waiver, they have to prove that it helps them achieve one of the following objectives: reduce average premiums, increase enrollment, stabilize the market, stabilize premiums for individuals with pre-existing conditions or increase the choice of health plans.

The second amendment proposed by Rep. Fred Upton (R-MI) provides an additional $8 billion over five years to the help cover the costs of individuals with pre-existing conditions.

The Congressional Budget Office (CBO) has not reviewed the revised bill. However, CBO previously estimated that the bill would reduce federal deficits by $337 billion and increase the number of uninsured Americans by 24 million.

Why is this important?

According to the ADA Health Policy Institute, dental care use among publically insured children had steadily increased from 30.6 percent utilization in 2000 to 41 percent rate in 2014. Under the bill, states have the ability to opt out of insuring pediatric dental care. This could be detrimental to providing preventive dental care for children in those states.

Additionally, several health care organizations are concerned that these amendments do little to address the gaps in funding the bill will create.

Next steps:

The bill now moves to the Senate for consideration, where it is likely to be modified. It is important to reach out to your senators to share your concerns about the bill and how it may affect the patients you serve.

Read more about the MacArthur amendment.

California introduces bills to improve Denti-Cal

What's the issue?

Assemblywoman Anna Caballero introduced Assembly Bill 753. The bill allocates more money from the state's tobacco tax toward dental services for children and adults participating in Denti-Cal, a program that provides dental care to low-income residents. In 2016, California voters approved the Healthcare, Research and Prevention Tobacco Tax Act. The bill increased the taxes imposed on cigarettes and enabled the state to use that revenue to increase funding for health care programs under Medi-Cal. Currently $191 million is allocated to improve dental services. Caballero's bill increases this to $300 million. The money would be used to increase payments to dentists that provide preventive dental services to adults.

AB 15 is another bill that attempts to address issues with the Denti-Cal program. Assembly Member Brian Maienschein's bill doubles the reimbursement rate for Denti-Cal providers for the 15 most common prevention, treatment and oral evaluation services. Revenues from the tobacco tax would be used to fund the increase in reimbursement rates.

Why is this important?

In 2014, a California state auditor's report indicated that fewer than half of the children eligible for Denti-Cal saw a dentist. Since then, California has strived to make improvements to the Denti-Cal program to reduce barriers to care.

It is important to monitor to these bills to determine if other states will begin to use excise taxes to fund health care initiatives.

Next step:

Read more about California's efforts. 

Reducing Barriers to Care Spotlight: Minnesota

On April 3, Gov. Mark Dayton signed Senate File 662 into law. The bill allows out-of-state dental students to work in Federally Qualified Health Centers (FQHCs) throughout Minnesota. Several FQHCs in Minnesota experienced shortages of dental students that could provide care.

Sen. Julie Rosen, author of the bill notes "greater Minnesota has a severe shortage of dentists. It shouldn't matter where a dental student attends dental school. As long as they are attending an accredited dental school, they should be able to provide this critical service while perfecting their skills under the strict supervision of licensed dentists."

Advocacy Brief shares news about ongoing issues and legislation that are of interest to dental students and organized dentistry. Inclusion of items does not imply their adherence to ASDA policy.