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House Begins Health and Education Funding Debate
The U.S. House of Representatives’ Appropriations Subcommittee
on the Departments of Labor, Health & Human Services (HHS), and Education
(ED) funding held its markup of the fiscal year (FY) 2024 bill last week. The
Subcommittee Chairman’s recommendation, which was not changed, calls for an
overall reduction in HHS programs by $17.4 billion (14%) from the current fiscal
year and a $22.5 billion (28%) reduction in ED programs.
Programs affecting higher education that are of interest were
not spared from cuts. The bill proposes no increase in the maximum Pell Grant
for the first time in over a decade. It also proposes the elimination of funding
for the Federal Work-Study program, affecting 660,000 students, and the elimination
of Research and Development Infrastructure Grants for historically black colleges
and universities, tribal colleges and universities and minority-serving institutions.
For HHS, the bill proposes the following:
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Eliminate the Agency for Healthcare Research and Quality;
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Provide no funding for the Health Careers Opportunity Program or Centers of Excellence;
- Cut $700 million in funding
for the Health Resources and Services Administration, the agency that administers
the Oral Health Training Program; and
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Reduce funding for the National Institutes of Health by $2.8 billion.
One ray of sunshine is that the recommended funding for the National Institute
for Dental and Craniofacial Research was not cut below the current year’s level.
The recommended amount is $520.2 million, however, ADEA and its dental association
partners are requesting the appropriation of $558 million in FY 2024.
The next step for the House bill will be a full Appropriations
Committee markup, possibly as early as next week. After that, ADEA AGR will provide
additional details about all program funding.
The
Senate Appropriations Committee has not announced a schedule for consideration
of its version of the bill as of yet. |
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Biden Administration Limits Duration of Short-term Health Insurance
The Biden administration issued a proposed rule that limits short-term health insurance plans to
four months. In the Affordable Care Act (ACA), short-term health insurance plans
were initially limited to a three-month duration. This was followed by the Trump
administration lengthening their duration to up to 36 months. These plans were
initially intended to provide stopgap coverage while individuals transitioned
between health plans and not year-round coverage as some do.
Because of their short duration, these plans were exempted
from most of the coverage requirements established by ACA. These plans are not
required to provide comprehensive coverage benefits, such as dental coverage for
children, prescriptions, mental health or maternity care, nor are they required
to accept individuals with pre-existing conditions. These plans tend to have very
limited coverage and, because of this, they are generally significantly more affordable
than health insurance plans offered by employers or offered in the ACA Marketplace.
Additionally, a 2021 report by the National Association of Insurance Commissioners
noted that short-term health insurance plans paid only 70% of the premiums in
claims, lower than the minimum of 80% required by the ACA. Though these plans
are not held to the ACA requirements, these numbers highlight the weak coverage that these plans provide.
In addition to rolling back the duration of short-term health
insurance plans to four months, this proposed rule also clarifies that short-term
policies can only last a total of four months, after which individuals would have
to find a longer-term insurer. This provision is meant to stop insurance companies
from continuously “renewing” an individual’s four-month insurance plan.
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Health Subcommittee Marks Up Dental Programs Reauthorization
Last week, the U.S. House of Representatives’ Energy and
Commerce Committee’s Health Subcommittee marked up seventeen bills. Nine of
the bills passed along ideological lines, while eight bills passed unanimously
along bipartisan lines. Three bills were of interest to the dental community:
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H.R. 3843, the Action for Dental Health Act of 2023, introduced
by U.S. Rep. Robin Kelly (D-Ill.), would reauthorize Section 340G of the Public
Health Service Act for fiscal years 2024 through 2028. This program provides support
for the dental health workforce, and it is one of the few bills that was passed
with unanimous bipartisan support. The final vote was 27 to 0.
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H.R. 3887, the Children’s Hospital Graduate Medical Education
(GME) Support Reauthorization Act of 2023, introduced by U.S. Rep. Dan Crenshaw
(R -Texas), would reauthorize payments to children’s hospitals that operate
Graduate Medical Education programs for fiscal years 2024 through 2028. However,
the bill also prohibits Children’s Hospital GME program funding from going to
children’s hospitals that offer “gender affirming care” to minors, including
surgeries, hormone therapy and puberty blockers. Thus, those hospitals would not
receive federal funding for their GME slots, which in turn would adversely impact
pediatric dental residencies. The final vote was 15 to 12.
- H.R. 4420, the Preparedness and Response Reauthorization Act,
introduced by U.S. Rep. Richard Hudson (R-N.C.), would reauthorize current programs
to support public health security and all-hazards response, including Strategic
National Stockpile (SNS), Biomedical Advanced Research and Development Authority
(BARDA) and Public Health Emergency Medical Countermeasures Enterprise (PHEMCE).
The bill also includes provisions aimed at enhancing transparency across the agencies,
supporting targeted research into certain medical countermeasures and streamlining
emergency response authorities. ADEA, along with other oral health partners, is
advocating to have dentists and dental students automatically included in this
bill as part of future emergency medical responses. The final vote was 16 to 12.
While H.R. 3843, the Action for Dental Health Act of 2023,
was very helpful and supportive of the oral health community, H.R. 3887, the Children’s
Hospital GME Support Reauthorization Act of 2023, has the potential to significantly
harm dentistry. According to Health Resources and Services Administration, in the academic
year 2021 -2022 , there were 516 Children’s Hospital GME-funded advanced dentistry
residents, including 415 pediatric dentists, 24 advanced general dentists and
23 pediatric orthodontists. The language in H.R. 3887 puts these GME-funded slots at risk. |
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