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American Dental Education Association
Volume 3, No. 9, July 25, 2023
Biden Administration Works to Keep People Insured as Millions Lose Medicaid
The Centers for Medicare & Medicaid Services (CMS) has required a half-dozen states to pause procedural terminations to correct errors through the Medicaid redetermination process. This information was released [ [link removed] ] during the agency’s July 19 press call.
The agency has required a half-dozen states to pause terminations and reinstate individuals whose Medicaid coverage was terminated without the full due process required.
“We are concerned, in particular, the majority of people that have lost coverage have lost coverage for what we call procedural reasons,” said Daniel Tsai, CMS Deputy Administrator and Director of the Center for Medicaid and CHIP Services, during the call. “We are using every lever that Congress has given us to hold states accountable to following all the federal requirements with Medicaid renewals.”
One of the most common issues the agency has identified is enrollees not being matched with the correct data to automatically re-enroll them in Medicaid.
According to the Kaiser Family Foundation, over 3 million Medicaid enrollees have been disenrolled [ [link removed] ] as of July 20, 2023, based on the most current data from 33 states and the District of Columbia.
CMS has also sent letters [ [link removed] ] to employers, plan sponsors and insurers encouraging them to voluntarily extend their plans’ health insurance coverage enrollment period, commonly called “open season,” through July 31, 2024. This gives employees who are losing Medicaid ample time to enroll in their group health insurance plans. CMS believes that “employees may not realize that they lost their Medicaid or CHIP coverage until they access care, since they may have missed notices from their state agency, and then missed their opportunity to enroll in other coverage,” which is why CMS is asking employers to extend their coverage enrollment deadline for the requested period of time.
The letter reminds employers that there are no legal or regulatory barriers to extending their coverage enrollment deadline and it encourages them to help inform their employees about the redetermination requirements and the need for the employees to contact their state Medicaid agency if they are currently covered by Medicaid.
House Energy and Commerce Full Committee Marks Up Dental Programs Reauthorization
The U.S. House of Representatives’ Energy and Commerce Full Committee marked up 15 health-related bills last week. The bills now move to the House floor. Three bills were of interest to the dental community:
• H.R. 3843 [ [link removed] ] , the Action for Dental Health Act of 2023, would provide extend dental health workforce programs under Health Resources and Services Administration until 2028. It passed unanimously.
• H.R. 4420 [ [link removed] ] , the Preparedness and Response Reauthorization Act, reauthorizes 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). This bill passed by a vote of 27 to 22.
• H.R. 3887 [ [link removed] ] , the Children’s Hospital GME Support Reauthorization Act of 2023, passed by a vote of 27 to 17. The bill, introduced by U.S. Rep. Dan Crenshaw (R -Texas), would reauthorize payments to Children’s Hospitals that operate Graduate Medical Education (GME) 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.
Several States Pass Legislation to Transition From Federal ACA Health Insurance Exchange to State-based Market
Under the Affordable Care Act (ACA), states have the option of running their own health care exchange markets [ [link removed] ] where consumers can shop for health insurance, or relying on the platform operated by the federal government. Several states have recently taken steps to transition from a federally run health insurance exchange to a marketplace that is operated by the states. A move that, according to supporters, would increase flexibility for enrollment and marketing and save each state money in the process.
In Georgia [ [link removed] ] , SB 65 [ [link removed] ] , which was signed by Gov. Brian Kemp (R) grants the Commissioner of Insurance the authority to “establish any advisory board or committee the Commissioner deems necessary for providing recommendations on the creation, implementation, or operation of an exchange.”
In Illinois [ [link removed] ] , Gov. J.B. Pritzker (D) signed HB 579 [ [link removed] ] , which requires the state’s Department of Insurance to operate the Illinois Health Benefits Exchange as a state-based exchange on the federal platform by plan year 2025 and as a state-based exchange by plan year 2026.
The Oregon State Legislature recently sent SB 972 [ [link removed] ] to Gov. Tina Kotek (D) that would require the Oregon Health Authority to transition from the federal platform to a state-based health insurance exchange by Nov. 1, 2026.
Eighteen states [ [link removed] ] currently operate their own exchange. Three operate a state-based exchange on the federal platform, and 30 states use the federally facilitated marketplace.
ADEA Advocacy in Action
This appears weekly in the ADEA Advocate to summarize and provide direct links to recent advocacy actions taken by ADEA. Please let us know what you think and how we might improve its usefulness.
Issues and Resources
• ADEA report [ [link removed] ] on teledentistry
• ADEA report [ [link removed] ] on the Impact of the COVID-19 Pandemic on U.S. Dental Schools
• ADEA policy brief [ [link removed] ] regarding overprescription of antibiotics
• For a full list of ADEA memos, briefs and letters click here [ [link removed] ] .
Key Federal Issues [ [link removed] ]
ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [link removed] ]
Key State Issues [ [link removed] ]
The ADEA Advocate [ [link removed] ] is published weekly. Its purpose is to keep ADEA members abreast of federal and state issues and events of interest to the academic dentistry and the dental and research communities.
©2023
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
Tel: 202-289-7201
Website: www.adea.org [ [link removed] ]
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B. Timothy Leeth, CPA
ADEA Chief Advocacy Officer
Bridgette DeHart, J.D.
ADEA Director of Federal Relations and Advocacy
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
Zachary Fessler
ADEA Program Manager for Advocacy and Government Relations
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