May 2019 Volume LIV Number 3


Legislative and Regulatory Update

May 2018 Volume LIII Number 3

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


On March 5-7, 2018, nearly 300 AAPD members from 36 states and D.C., advocated for children’s oral health in Washington, D.C., by visiting with their members of Congress. AAPD attendees included members of the Council on Government Affairs, PAC Steering Committee, Executive Committee, and Budget and Finance Committee. Twenty-nine AAPD state Public Policy Advocates particpated as well. Thirty-six pediatric dentistry residency programs were represented, with more than 175 residents in attendance. For the third year, the AAPD held a special pre-conference advocacy orientation and training session for residents.

Attendees heard updates on key AAPD public policy issues focusing on Title VII pediatric dentistry funding and student loan repayment reform legislation, as well as an update from the ADA on the Affordable Care Act, Medicaid, and CHIP. The keynote speaker was Michael Barone, currently Senior Political Analyst for The Washington Examiner, Resident Fellow at the American Enterprise Institute, and contributor to Fox News. Mr. Barone discussed the current political landscape and the upcoming 2018 Congressional mid-term elections. The AAPD PAC hosted a fundraiser for Congressman Tom Cole (R-Okla.-4th), chair of the House Appropriations Subcommittee on Labor, Health and Human Services, and Education. Mr. Cole is a fifth generation Oklahoman and an enrolled member of the Chickasaw Nation. He is one of only two tribal members currently serving in Congress. The event, co-sponsored with ADPAC, AAOMS PAC and Hogan Lovells PAC, raised over $15,000.

The specific advocacy requests made by attendees during Capitol Hill visits were:

Fund Title VII Pediatric Dentistry
Provide FY 2019 funding of $40.763 million for the primary care dental Title VII program with $12 million for Title VII Pediatric Dentistry that includes funding for the Dental Faculty Loan Repayment Program. As part of this effort, attendees urged House Members to sign onto a Dear Colleague letter circulated by Congresswoman Julia Brownley (D-Calif.-26th) and Congressman Gregg Harper (R-Miss.-3rd) that asked Members to Support Bipartisan Call for Investment in Pediatric Dental Care. The final letter included 38 signatures and will be printed in the July 2018 PDT.

Make dental faculty loan repayments non-taxable to recipient or allow institutions to offset tax liability. Dental faculty loan repayment program would have even greater impact if made non-taxable to recipient or if institutions were allowed to use grant funds to offset tax liability.

Support H.R. 372, repeal of antitrust exemption for health insurance companies.
H.R. 372, repeal of the McCarran-Ferguson Act, was approved by the House on March 22, 2017. A Senate bill has yet to be introduced.

• Support H.R. 4001, student loan refinancing and restoration act. H.R. 4001 would:
- Allow borrowers to refinance their student loan interest rates to the 10-year Treasury note rate, plus one percent, throughout the lifetime of the loan.
- Eliminate origination fees and instead set future student loan interest rates at the 10-year Treasury note rate, plus one percent.
- Delay student loan interest rate accrual for many low- and middle-income borrowers while they are in school.
- Allow for borrowers in medical or dental residencies to defer payments until the completion of their programs.

Fact sheets used in Congressional visits are available on the AAPD website at sheets/.

We sincerely thank all those members who took time from their busy schedules to attend this important conference. Many thanks to the state and district chapters which help support residents’ attendance at the conference.


The March 2018 PDT described advocacy efforts to reauthorize the Children’s Health Insurance Program (CHIP), which plays a critical role in the coverage landscape for children. Together, CHIP and Medicaid provide health care coverage to more than 36 million children. Medicaid provides coverage for over 30 million children, and CHIP builds on that foundation to provide coverage for over 6 million children who are not eligible for Medicaid, but lack access to affordable health coverage. Although funding lapsed on Sept. 30, 2017, Congress acted on Jan. 22, 2018, to pass a six-year CHIP extension, and again on Feb. 9, 2018 to extend CHIP for an additional four years through FY 2027. During PPAC Congressional visits, AAPD attendees thanked all Senators and Representatives for their support of CHIP reauthorization.

CHIP Background: CHIP was created in 1997 with strong bipartisan support to provide coverage for children who fell above Medicaid eligibility levels but lacked access to other options. CHIP was specifically designed to include child appropriate benefits, access to pediatric providers, and cost-sharing limits to protect children and families. States that provide CHIP coverage to children through a Medicaid expansion program are required to provide the EPSDT benefit, which includes dental coverage. Dental coverage in separate CHIP programs is required to include coverage for dental services "necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions." States with a separate CHIP program may choose from two options for providing dental coverage: a package of dental benefits that meets the CHIP requirements, or a benchmark dental benefit package. The benchmark dental package must be substantially equal to: (1) the most popular federal employee dental plan for dependents; (2) the most popular plan selected for dependents in the state’s employee dental plan; or (3) dental coverage offered through the most popular commercial insurer in the state.

CHIP is one of the reasons that 90 percent of children in the U.S. currently have dental insurance coverage.

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