Senate bill encourages state Medicaid expansion

What's the issue?

On April 13, Sens. Mark Warner (D-Va.) and Debbie Stabenow (D-Mich.) introduced S. 2728, the States Achieve Medicaid Expansion (SAME) Act of 2016.

Under the Affordable Care Act, Medicaid expansion was intended to be national by 2014. However, the Supreme Court decision in the National Federation of Independent Business v. Sebelius case gave states the opportunity to opt out of expanding Medicaid. As a result, only states that chose to expand Medicaid by 2014 were eligible for federal assistance.

The bill would allow all states to receive federal assistance to expand Medicaid coverage regardless of when such expansion takes place.

If enacted, states would receive three years of full federal funding, phasing down to a 95 percent Federal Medical Assistance Percentage (FMAP) in year 4; a 94 percent federal contribution in year 5; a 93 percent in year 6; and 90 percent for each year thereafter.

Why is this important?

Medicaid provides public health insurance to seniors, people with disabilities and children from low-income families. Currently, 19 states have not expanded their Medicaid programs. This bill encourages those states to address the health care concerns of underserved communities.

Next step:

Learn more about the SAME Act.

Vermont passes dental therapist bill

What's the issue?

On April 26, the Vermont House of Representatives passed S.20. The bill establishes a dental therapist as an additional member of the dental team. Under the bill, the dental therapist would be able to formulate treatment plans, prescribe medication and extract primary teeth.

In order to become a licensed dental therapist, applicants must graduate from a four-year educational program. The applicant would receive the same curriculum as a dental hygienist for the first three years and then spend an additional year in training.

This bill is expected to be signed by Governor Peter Shumlin within the coming weeks.

Why is this important?

According to ASDA's C-2 policy, the dentist is the only dental provider that should perform the following functions: examinations, diagnosis, treatment planning and surgical/irreversible procedures.

In 2014, ASDA members sent 647 letters to legislators in Vermont urging them to vote against a similar dental therapist bill. Although Vermont passed dental therapy legislation this year, ASDA continues to advocate against mid-level provider legislation in other states in the northeast. In January, ASDA members sent close to 100 letters to legislators in Massachusetts, urging them to oppose S. 2076, a bill that would establish dental hygiene practitioners within the state.

Next step:

Read more about S. 2076.

Legislation Update The March issue of Advocacy Brief discussed Maine's dental hygiene therapist bill, L.D. 1514. The act proposed changing some of the training, supervision and accreditation requirements for dental hygiene therapists practicing in Maine. On April 29, the bill was vetoed by the governor. The Maine House of Representatives voted to override the governor's veto; however on the same day, the Senate sustained the veto. Therefore, L.D. 1514 will not be enacted into law.

State student loan repayment programs

What's the issue?

The average indebted dental student graduates with $247,227 of student loan debt. Below are examples of states that administer successful student loan repayment programs.

Sixty-five of Iowa's 99 counties do not have enough dentists to treat patients. To help meet this need, Iowa developed a program in 2002 to help attract students to practice in those counties.

Under the program, participants receive $50,000 from Delta Dental of Iowa, $25,000 from the state and $5,000 or more from local communities.

Recipients can apply the money directly to their student debt. In order to receive the money, participants must agree to practice in an area designated as a dental shortage area and treat patients from underserved populations.

Twenty-eight of the 31 dentists who received money under this program have remained in Iowa.

Other states offer generous loan forgiveness programs for practicing in underserved areas. In Alaska, dentists can earn up to $35,000 a year for three years in exchange for working in underserved communities.

The California State Loan Repayment Program will award up to $50,000 per year for repayment of federal or private student loans for a two-year commitment to practice full-time in an underserved area.

Why is this important?

According to ASDA's F-4 policy, the association encourages state legislatures to provide loan forgiveness of tuition for dental students and residents practicing in underserved areas after graduation.

It is important for you to be aware of all the career options available to you after graduation.

Next steps:

Read more about the student loan forgiveness programs offered in each state.

Read more about the success of the Iowa program.

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.