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Volume 1, No. 51, March 3, 2020

New Jersey Weighs New Cigarette Tax
 
New Jersey Gov. Phil Murphy (D) has proposed a trio of new taxes in his 2021 budget [ [link removed] ] with the goal of collecting potentially $400 million annually in new revenue. The proposed revenue enhancers include a tax on companies who do not insure their employees, a pill tax on the manufacturers of opioids and a substantial increase to the current tax on cigarettes.
 
The new cigarette tax would raise the fee from $2.70- to $4.35-per pack [ [link removed] ] , which doesn’t include the current 6.6% sales tax. The $2.70 tax on cigarettes generated $71 million annually in revenue and the $1.65-per pack increase is meant to push that total to $215.8 million [ [link removed] ] . The proposed tax increase on cigarettes has been heralded by anti-smoking groups who have long advocated it as a way to drive consumers away from cigarettes and improve public health. If enacted, the new tax would make New Jersey, along with Connecticut and New York [ [link removed] ] , one of the most expensive places to buy cigarettes.
 
Gov. Murphy previously introduced similar policy initiatives, such as in last year’s budget, but they did not progress in the state legislature. State officials are hopeful that the new revenue will allow them to invest $340 million to offset Medicaid costs, $2 million in anti-smoking campaigns and $100 million to be invested in addiction services. The proposal for this year must be approved by the legislature by July 1.

Update: Trump Administration Requests $2.5 billion for Coronavirus Response
 
On Feb. 24, the Trump Administration submitted to Congress a supplemental appropriations request that would direct an additional $2.5 billion to the coronavirus (COVID-19) response. However, only $1.25 billion in that request is new money; the remaining balance the Administration is seeking would be funding it wishes to “re-prioritize” from other U.S. Department of Health and Human Services (HHS) programs to COVID-19 preparedness and response.
 
HHS Secretary Alex Azar provided the Senate Appropriations Committee, during his budget hearing on Feb. 25, with a two-page table of where funds will be re-prioritized within HHS. Below are some items of interest:
 • $2.3 million would come from the Centers for Disease Control and Prevention’s (CDC) Chronic Disease Prevention & Health Promotion, out of the total $985 million appropriated in fiscal year (FY) 2020. This is the account that contains the Oral Health Division, but no information is available about whether any of Oral Health funds will be reduced.
 • $1.7 million would come from Health Resources and Services Administration’s Health Workforce, out of the total $885.6 million appropriated in FY 2020. This is where the Oral Health Training programs, as well as the Medical and Nursing Training programs, are funded. Again, no additional details are available yet.
 • $63 million would come from the National Institutes of Health, out of a total $40.2 billion appropriated in FY 2020. Of this amount, $964,000 would come from National Institute of Dental and Craniofacial Research, which has a total $477 million appropriation in FY 2020.

Much of the proposed re-prioritizing will require new authority from Congress to do so. Bipartisan Members of Congress, including the House Republican leader, expressed concern that the proposal did not adequately address the current threat or provide a plan for responding to its possible spread in the United States. Senate Democratic Leader, Sen. Charles Schumer (D-NY), has proposed an $8.5 billion emergency appropriation to address the COVID-19 threat.
 
On Feb. 26, the President held a briefing where he asked Vice President Mike Pence to oversee the federal response to the virus. On Feb. 27, the Vice President and Secretary Azar met with the President’s Coronavirus Task Force, all of whom are White House or federal agency officials.
 
Last week, in the ADEA Advocate, we reported that CDC was expected to release guidance for institutions of higher education on handling COVID-19 cases and outbreaks. As of this writing, such guidance has not been forthcoming.

Bill Prohibiting Pediatric Care Waiting Periods Passes Senate in Maine
 
The Maine State Senate has approved a bill (LD 1975 [ [link removed] ] ) authored by State Sen. Heather Sanborn (D) to prohibit waiting periods [ [link removed] ] for pediatric dental care. The bill aims to end the practice of private dental insurance requiring a waiting period of anywhere from three to six months for patients under the age of 19.
 
Many insurance companies require a waiting period for new patients in order to discourage them from putting off dental work until they have coverage and then dropping the insurance plan once the treatment has been completed.
 
While many dental plans cover preventative care on an immediate basis, patients often face a waiting period for more serious concerns when they’ve signed up for a new plan. The bill [ [link removed] ] focuses on patients who purchase family plans and then face a waiting period for both children and adults. Adults could still experience a waiting period under this legislation. The legislation includes an exception for orthodontic care for those under 19 years of age.
 
Former President of the Maine Dental Association Dr. Jonathan Shenkin [ [link removed] ] has been an advocate for this bill since seeing the negative impacts the current system has had on his patients, especially in terms of the dental pain they’ve experienced. Dr. Shenkin brought the issue [ [link removed] ] to the attention of Sen. Sanborn and thinks that if the bill is enacted, it would make Maine the first state in the country to end pediatric waiting periods.

CMS Enhanced Oversight of Hospital- and Facility-accrediting Organizations Likely
 
At last week’s 2020 Centers for Medicare & Medicaid Services (CMS) Quality Conference, CMS Administrator Seema Verma expressed deep concern over hospital- and facility-accrediting organizations not properly performing their job.
 
Verma stated that these organizations had a “sacred public trust responsibility” bestowed on them by CMS “to inspect and deem health care providers compliant with Medicare’s quality standards.” She also expressed concerns over the fee-based consulting arms of accrediting organizations that help providers through the accreditation process as well as concerns about the standards being used by accrediting organizations to inspect hospitals and facilities. Verma questioned whether the accrediting organizations were using CMS-established standards during the inspections, which the organizations are supposed to be using.
 
Verma hinted that the industry should expect enhanced CMS oversight of the accreditation process in the near future [ [link removed] ] .

U.S. House of Representatives Codifies and Expands FDA Limited Ban on Tobacco Products
 
U.S. House of Representatives passed H.R. 2339 [ [link removed] ] , the Protecting American Lungs and Reversing the Youth Tobacco Epidemic Act, by a vote of 213 -195.
 
The bill codifies the U.S. Food and Drug Administration’s limited ban on non-tobacco products, which went into effect in February. The bill also closes a loophole in the ban by including menthol flavored e-cigarettes. Finally, the bill bans online sales of e-cigarettes and restricts advertising and marketing of those products.
 
It was not a straight party-line vote [ [link removed] ] , with 17 Democrats opposing the bill, most of whom were members of the Congressional Black Caucus (CBC). African Americans disproportionately use menthol e-cigarettes, and because of this, some CBC members were concerned that this bill would give police another reason to disproportionately target African Americans. The American Civil Liberties Union also opposed the bill, echoing the concerns asserted by those CBC members.
 
However, there were many prominent advocacy groups, such as the American Cancer Society, American Heart Association and the American Lung Association, who supported the bill. These groups believe that the bill will be the most effective way to lower the growing youth vaping rates. The U.S. federal government estimates that 5.4 million middle and high school students used e-cigarettes in 2019.

Late Breaking from the Supreme Court
 
On March 2, the U.S. Supreme Court announced that it will take up the Texas v. Azar case regarding the Affordable Care Act that is currently pending in the Northern District of Texas Federal Court. No schedule for consideration was announced, but it is likely that the case will be argued before the Court this fall and a decision would likely follow in the spring 2021. More information regarding this case will be available in future editions of the ADEA Advocate.

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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.
 
©2020
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
202-289-7201, 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
 
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
 
Brian Robinson
ADEA Program Manager for Advocacy and Government Relations
 
Ambika R. Srivastava, M.P.H.
ADEA/Sunstar Americas, Inc./Jack Bresch Legislative Intern
 
[email protected] [ mailto:[email protected]?subject=State%20Update%3A%20 ]

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