Negotiated rulemaking discussions about student debt end

After the U.S. Supreme Court rejected President Biden’s student loan debt relief proposal (as discussed in the July issue of Advocacy Brief), the Administration and U.S. Department of Education announced a “new path” for loan forgiveness that would seek to make changes via a different process called negotiated rulemaking.

This consensus-based negotiated rulemaking process is a lengthy technique through which an agency develops a proposed rule by using a neutral facilitator and a balanced negotiating committee comprised of representatives of all affected interests. The negotiated rulemaking sessions began in October and ended on December 12. While some consensus was reached, other provisions are still in question.

The draft text will be issued as a Notice of Proposed Rulemaking and released for public comment in May 2024. The rule is expected to be finalized before the end of 2024 and implemented in 2025. 

CMS releases rule as states resume Medicaid eligibility 

During the pandemic, the federal government prohibited states from ending Medicaid participants’ coverage. This process ended in April 2023 when states were required to resume evaluating beneficiaries’ eligibility. Since then, over 1.3 million people have been disenrolled from Medicaid. In some states, more than 80% of disenrollments were due to “procedural reasons,” where participants were disenrolled, but may still be eligible. 

Now, as states restore Medicaid eligibility, the Centers for Medicare & Medicaid Services (CMS) has published an interim final rule with consequences for states that fail to comply with new reporting requirements. States may be required to submit a corrective action plan, stop “procedural” disenrollments, and pay penalties. For failing to meet reporting requirements, CMS may also reduce the percentage of money it gives to the state to assist with Medicaid expenses. The interim final rule was effective on Dec. 6, 2023. CMS is receiving comments through February 2. 

Utah votes to keep fluoridated water

In a special election in November, residents of Bringham City, Utah voted overwhelmingly in favor to keep fluoride in their drinking water. Proposition 3 sought to remove fluoride in an effort to reduce costs for the city of 20,000 residents. Key efforts to educate the public and call on advocates defeated the measure seeking to remove fluoride in the community water, which has been in place since 1965. 

Why does it matter? ASDA encourages the fluoridation of community water supplies at optimal levels as determined by the U.S. Department of Health and Human Services. ASDA supports the use of fluoridated products as recommended by the Centers for Disease Control and Prevention. 

Proposed Wisconsin rule would expand dental hygienist

The Wisconsin Dentistry Examining Board has proposed a rule that would allow dental hygienists to apply topical anesthetics without the presence of a licensed dentist. Every state makes its own rules regarding the scope of dental hygienists and anesthesia in that state. For example: 

• In Illinois, the Illinois Administrative Code specifies that the dental hygienist must function under the supervision of a dentist who remains in the facility when administering local anesthesia.  

• In Michigan, a dental hygienist may apply topical anesthetic agents by prescription of a dentist and subgingival medicaments under assignment from a dentist. Assignment means that the dentist has designated a patient and described the procedures to be performed but does not need to be physically present at the time of those procedures being performed.  

• In Minnesota, a dental hygienist may administer local anesthesia and place subgingival medicaments under the general supervision of a dentist, but they must first successfully complete a didactic and clinical program accredited by CODA. 

Under the Wisconsin proposal, this would be permitted if the procedure is performed under a written or oral prescription, and the dentist who wrote the prescription has seen the patient at least once during the 12-month period immediately preceding the procedure. A public hearing on this proposal was held on Jan. 3, 2024. 

2024 elicits ban on indoor e-cigarette use in Illinois



January 1, 2024 marked the first day people in Illinois could not use vapes and other e-cigarette products inside public places. When the Smoke-Free Illinois Act went into effect in 2007, it prohibited the use of cigars and cigarettes inside and within 15 feet of entrances. This new law strengthens the Smoke-Free Illinois Act by prohibiting all e-cigarette usage indoors. 

Why does it matter? ASDA’s I-4 policy discourages the use of tobacco, e-cigarettes, vaping products and alternatives.