March 2019 Volume LIV Number 2


Legislative and Regulatory Update

March 2018 Volume LIII Number 2

Unless otherwise noted, for further information on any of these issues please contact Chief Operating Officer and General Counsel C. Scott Litch at (312) 337-2169 or

Federal News


In the fall of 2017 the Health Resources and Services Administra- tion (HRSA) awarded 13 grants to dental education institutions to enhance clinical predoctoral dental and dental hygiene training focus- ing on children ages 0-5 to improve the oral health of vulnerable, underserved, and rural pediatric populations. Thanks to AAPD advo- cacy efforts that obtained FY 2017 federal funding, HRSA allocated $4.4 million for this competition, which includes a small childhood obesity prevention supplement. These are five-year awards, with up to $300,000 available per grantee per year.

The 13 awardees are:

University of Alabama at Birmingham Ala.
Western University of Health Sciences Calif.
Meharry Medical College Tenn.
Nova Southeastern University Fla.
University of Hawaii Hawaii
University of Illinois Ill.
Boston University Mass.
University of Michigan Mich.
Temple University Pa.
University of Pennsylvania Pa.
University of Texas Health Science Center at San Antonio Texas
Virginia Commonwealth University Va.
University of Washington Wash.


Congressional efforts by the Republican Majority to "repeal and replace" the Affordable Care Act (ACA) were not successful in 2017. An ACA open enrollment period took place (albeit shorter than the prior year) and – while the final tax reform bill did eliminate the ACA individual mandate penalty – the final FY 2018 funding bill may provide some "stabilization" subsidies for insurers in the ACA. So as 2018 dawned the ACA lives on. Note that starting in 2019 there will be premium tax assistance for purchase of stand-alone dental plans for those who purchase a qualified health plan that does not provide pediatric dental benefits.

On Nov. 27, 2017, the AAPD and ADA filed joint comments with the Centers for Medicare and Medicaid Services (CMS) on proposed changes to the benefits and payment parameters under the Affordable Care Act (ACA). Among other changes, the proposal would allow states to limit their essential health benefits packages after Jan. 1, 2019. This could negatively impact pediatric oral health coverage, as that is one of the 10 essential health benefits.


On Dec. 15, 2017, the AAPD along with the ADA and the Organized Dentistry Coalition wrote a letter to CMS requesting ap- pointment of a new Chief Dental Officer (CDO) despite the federal hiring freeze. Dr. Lynn Mouden stepped down as CMS CDO last summer. Slightly before that Laurie Norris, Senior Policy Advisor for Oral Health, also left CMS. The AAPD is seriously concerned about a leadership void in oral health expertise at the agency. The letter to Eric D. Hargan, acting secretary of the US Department of Health and Human Services, asked the agency not only to fill the vacant position, but also to prioritize oral health services in a manner equal to medical services.


AAPD has continued our advocacy for reauthorization of the Children’s Health Insurance Program (CHIP) and actively engages our state Public Policy Advocates (PPAs) and e-Advocates network in these efforts. On Sept. 30, 2017, Congress allowed CHIP to expire, potentially impacting nearly nine million children’s access to oral health care. On Nov. 29, 2017, we joined the ADA in calling for a Day of Action for CHIP Reauthorization, asking dentists to e-mail their Members of Congress via a link provided by ADA.

A joint AAPD-ADA letter from Presidents Nickman and Crowley was sent to key Congressional leaders on Dec. 14, 2017, as described in the ADA’s Morning Huddle:

The ADA News (12/14, Garvin) reports that the American Dental Association and American Academy of Pediatric Den- tistry are again asking Congress to reauthorize the Children’s Health Insurance Program in order to improve "access to oral health care for all Americans." In a Dec. 14 letter, ADA Presi- dent Joseph P. Crowley and AAPD President James D. Nickman said, "It has been 75 days since CHIP’s authorization expired and while we appreciate the work that has been done in both the House and Senate to move toward passing legislation, we cannot wait any longer." Drs. Crowley and Nickman noted that "dental care has the highest level of cost barriers compared to other health care services," and they stressed that poor oral health can have a negative effect on overall health as well as an economic impact on the nation’s health care system. "As health coverage costs continue to rise, CHIP provides a safety-net for families in every state," Drs. Crowley and Nickman wrote.

We are pleased to report that in February 2018, Congress did reauthorize CHIP for 10 years. More details will be provided in the May PDT.

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