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Federal Budget and Oral Health Funding Outlook
President
Biden and the Congress reached an agreement to extend the federal debt limit through
Jan. 1, 2025. To implement the extension and set the stage for the funding parameters
on next fiscal year’s budget, Congress passed and the President signed the Fiscal Responsibility Act (FRA) (H.R. 3746) on June 3.
As part of the agreement there will be enforceable discretionary
budget caps on federal funding for fiscal years (FY) 2024 and 2025. The increase
between FY 2024 and FY 2025 is 1%. However, the non-defense discretionary (a.k.a.,
domestic discretionary) spending limits decreased by $43 million from the current
FY 2023 levels. Between now and the start of FY 2024 on Oct. 1, the Committees
on Appropriations in the U.S. House of Representatives and Senate will decide
where those cuts will occur. Much of that burden may fall on the departments,
agencies and programs funded by the House and Senate Labor, Health and Human Services,
Education Subcommittees, which fund oral health training programs, dental and
craniofacial research and higher education. No programs will be immune from possible
reductions. Moreover, both Houses will be pressured to provide additional funds
for VA Health Care, which is a discretionary program, and support for humanitarian
needs at the southern U.S. border.
In
the coming months, ADEA will actively make the case for funding oral health workforce
and dental and craniofacial research needs, and it will need ADEA members’ help.
Please watch for requests to contact your Members of Congress!
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Biden Announces NIH Director and CDC Director
President
Biden recently nominated two women to head major federal health care agencies.
The President nominated Dr. Monica Bertagnolli to lead the National Institutes of Health
(NIH), succeeding Dr. Francis Collins, who served as NIH Director for more than a decade.
Dr. Bertagnolli is a surgical oncologist and cancer researcher
who is currently Director of the National Cancer Institute (NCI), the first woman
to serve in this role. At NCI, Dr. Bertagnolli has worked to further President
Biden’s Moonshoot Cancer Initiative. Previously, she served as the Richard E.
Wilson Professor of Surgery in surgical oncology at Harvard Medical School, a
surgeon at Brigham and Women’s Hospital, and a member of the Gastrointestinal
Cancer Treatment and Sarcoma Centers at Dana-Farber Cancer Institute, all in Boston.
She has also served as group chair of the Alliance for Clinical
Trials in Oncology, a National Clinical Trials Network member organization, and
was CEO of Alliance Foundation Trials, LLC, a not-for-profit corporation that
conducts international cancer clinical trials and focuses on the inclusion of
rural communities in clinical studies. Dr. Bertagnolli awaits Senate confirmation.
President Biden also plans to nominate Dr. Mandy Cohen, an internal medicine physician, to lead the
Centers for Disease Control and Prevention, replacing Dr. Rochelle Walensky, who
is stepping down on June 30. Since January 2022, Dr. Cohen has been CEO of Aledade
Care Solutions and Executive Vice President of Aledade Inc., a primary care network.
Prior to Aledade, she served as North Carolina's Secretary of Health and Human
Services starting in 2017. During her five years at the agency, she shepherded
the state through the COVID-19 pandemic, implemented the state’s Opioid Action
Plan and helped pass Medicaid expansion in the state.
Dr. Cohen has held senior positions at the Centers for Medicare
& Medicaid Services during the Obama administration, including Chief Operating
Officer and Chief of Staff at the agency, and served as Acting Director of the
agency’s Center for Consumer Information and Insurance Oversight. |
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U.S. Supreme Court Upholds Medicaid Beneficiaries’ Right to Sue
Last week, the Supreme Court ruled 7-2 to protect the right of private individuals’ right
to sue state and local actors for violations of their federal civil rights under
Section 1983. Specifically, in Health and Hospital Corporation
of Marion County v. Talevski, the court held that Medicaid nursing home residents
can seek relief in federal court under Section 1983 when state officials do not
meet a certain quality of care established by statute. This case reaffirms and
preserves federal Medicaid guarantees as privately enforceable legal rights.
The case centered around Gorgi Talevski, who resided in a nursing
facility owned by Health and Hospital Corporation of Marion County where he was
both physically and chemically restrained and later involuntarily moved to a different
facility. Mr. Talevski’s family sued the nursing facility’s owners under Section
1983 for depriving him of his federal rights guaranteed by Medicaid’s Federal
Nursing Home Reform Act (FNHRA). FNHRA is a 1987 federal law governing nursing
homes that receive federal funding. The law includes a provision that prohibits
nursing homes from using physical restraints or chemical restraints for nonmedical reasons.
Historically, the courts have recognized Section 1983 as a vehicle for private
citizens, including beneficiaries of public welfare programs such as Medicaid,
to protect their federal rights when state governments or actors violate them.
Mr. Talevski’s family won their case at the federal appeals level. However,
the nursing facility asked the Supreme Court to overturn this decision. The nursing
facility claimed FNHRA, and statutes like it, act as common contracts and that
under common contract law, the contractual obligations are between the federal
government and fund recipients—in this case the state Medicaid program—and
that third-party beneficiaries of these contracts, like nursing home residents,
cannot enforce these contracts under Section 1983. The court rejected the nursing
facility’s argument and through its ruling made it clear that Section 1983 continues
to be a mechanism through which private citizens can protect their federal rights
when state governments or actors violate them.
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