Health Reform Update
As you are surely aware, both chambers of Congress have not passed health reform legislation. The House passed a health reform bill in November and the Senate passed its health reform bill on December 24th. Congress has been moving forward with the process of negotiating a compromise health reform bill– a process referred to as reconciliation.

The election of Scott Brown, a Republican from Massachusetts, to the Senate on January 19, 2010 has eliminated the Democrats’ supermajority required to avoid a filibuster on health reform legislation. Brown’s election requires the majority leadership in both the House and Senate to reexamine strategies for getting a final health reform bill passed and to the President for signature into law. There are a number of options currently being considered to get a final bill passed, although at this time it is not clear how leadership will proceed and what, if any, impact those options will have on oral health provisions included in health reform legislation.

ADHA has sent updates to the dental hygiene community with information about health reform legislation several times as the process has unfolded. The updates outline the key provisions in health reform legislation and their impact on dental hygiene. As a state leader, you may be asked about ADHA’s position on health reform.

The following are some messages and resources that may prove useful in the event you do get questions about health reform:

• ADHA did not take a position for or against health reform – the association asserts that if health reform is to be undertaken (which Congress has made clear it is), oral health should be included as oral health is vital to total health.

• ADHA respects that there are many opinions about health reform within the dental hygiene community. Our current reality is that health reform legislation is moving through Congress and will likely be finalized in early 2010. As the national association representing the profession of dental hygiene, ADHA has a responsibility to be a part of the dialogue on health reform as a number of provisions will impact the dental delivery system and oral health providers.

• ADHA has developed a chart comparing the oral health provisions contained in both the House (HR 3962) and Senate (HR 3590) bills and their potential impact on dental hygiene.

1. Include the Senate bill language that establishes the alternative dental provider grant program in any final version of health reform legislation.
2. Include the House bill language requiring oral health expertise be included on any health benefits advisory committees/boards in any final version of health reform language.
3. Ensure that the Title VII provisions pertaining to the dental workforce remain inclusive of dental hygiene.

As a point of information, the following is a brief overview of oral health provisions contained in the Senate health reform bill passed on December 24th:

- Pediatric Dental Benefit: The bill requires a dental benefit be included as part of the essential health benefits package for all eligible children (through age 21) who receive coverage through the newly-created health insurance exchange. The bill does not include an adult dental benefit.

- Contracting with Stand-alone Dental Plans: The bill would allow stand-alone dental plans to operate as part of health insurance exchanges to meet pediatric dental benefit requirements. The provision accommodates the way the current system is structured in that most medical plans do not include dental benefits and most dental insurance plans are offered separate from medical plans.

- Alternative Dental Health Care Provider Demonstration Project Grants: The bill would allocate up to $60 million for the education and demonstration of alternative dental health care providers, including dental hygiene and advanced practice dental hygiene workforce models.

- Oral Health Workforce Provisions: The bill includes a section that would establish programs and allocate federal monies to expand and develop the dental workforce. The provisions include dental hygienists, dental hygiene students, and dental hygiene education programs as eligible entities for funds.

- Medicaid Reimbursement/Eligibility Levels: The bill would extend Medicaid eligibility to all individuals at 133% of the federal poverty level (FPL).

- Oral Health Programs in School-based Clinics: The bill would establish a grant program for school-based health clinics, including those that offer oral health services.

- Oral Health Infrastructure and Surveillance: The bill would establish a number of oral health education and surveillance programs to improve the public’s understanding of the importance of oral health and collect data on access to oral health services.

Please know that ADHA staff is available to answer questions and offer additional information, just e-mailor call Megan Fitzpatrick at 312.440.8942.