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American Dental Education Association

Volume 2, No. 37, January 11, 2022

U.S. Supreme Court Hears Challenges to Biden’s Vaccine Mandates
 
On Jan. 7, the U.S. Supreme Court heard oral arguments in two cases challenging the Biden administration’s COVID-19 vaccine mandate for health care providers and for employers with 100-plus employees. These two cases, filed in November 2021, quickly made it to the Supreme Court for its review. Given the spread of the Omicron variant and its impact on the health care system and the economy, it is likely the Court will rule on these two cases soon.
 
Based on oral arguments, it seems likely the Court will issue a “Solomonic judgment”-like ruling in favor of the Biden administration’s vaccine mandate for health care workers and against the vaccine mandate for employers.
 
The justices noted that the vaccine mandate for health care providers [ [link removed] ] , issued by the Centers for Medicare & Medicaid Services, rests on precedent governing facilities receiving federal money. It is specifically in line with previous federal oversight of medical facilities through regulations issued by the Medicaid and Medicare programs. The justices also noted that the majority of the medical establishment supports the vaccine mandate for health care providers.
 
However, the Court seemed skeptical of the government’s argument [ [link removed] ] in support of the Occupational Safety and Health Administration’s (OSHA) mandate governing employers with 100-plus employees. The justices questioned OSHA’s legal authority to impose what was interpreted as a wide-ranging rule. They also expressed their concern that there was no precedent for using OSHA regulations in this manner, stating that states and Congress would be better suited to issue vaccine mandates.

Congress Opens the New Year with Some Unfinished Business
 
When the U.S. House of Representatives and Senate left the nation’s capital, several items were left unfinished and will be high on the to-do list early in the new year.
 
Fiscal Year (FY) 2022 Appropriations - There have been no negotiations between the House and Senate about the final configuration of any of the 12 appropriations bills. However, now that the National Defense Authorization Act [ [link removed] ] has been signed into law, there have been hopeful discussions on what the topline numbers will be for Defense and non-Defense discretionary budget. This agreement on the topline is a prerequisite to final decisions on various program funding. A continuing resolution is keeping the government operating at the FY 2021 levels until Feb. 18.
 
Build Back Better Act - This is a broad piece of legislation that the Biden administration considers to be the human infrastructure counterpart to its recently enacted physical infrastructure legislation, Infrastructure Investment and Jobs Act [ [link removed] ] . The House passed its version on Nov. 19, 2021, and the Senate is attempting to work its way through various Democratic concerns.
 
The House bill [ [link removed] ] and Senate proposals include several provisions involving the Medicaid program that will be of interest to dental schools and allied programs. For instance, the House-passed bill would:
 • Make permanent the Children’s Health Insurance Program, which to date has simply been extended periodically;
 • Increase the Federal Medical Assistance Percentage by an additional 6% above the current level;
 • Close the coverage gap affecting low-income individuals living in the 12 states that have not expanded Medicaid; and
 • Extend coverage to all pregnant women one year postpartum.

There are additional provisions which should also improve access to oral health services by enhancing the public health infrastructure and assisting community health centers.
 
ADEA will provide a more in-depth summary and analysis when the final legislation is adopted.

2022 is a Big Election Year
 
In 2022 at the federal level, all 435 seats in the U.S. House of Representatives and 34 Senate seats will be on the ballot. Since World War II, in mid-term elections, the president’s party loses an average of 26 seats in the House and four in the Senate. A similar outcome in 2022 would change the party leadership of both congressional houses. This is not unusual; after the Carter administration, no president has seen his party control both Houses for his entire term.
 
In addition, there are two factors that will make 2022 interesting and probably confusing: first, redistricting (which follows each decennial census) and second, partially because of redistricting, is the number of retirements from each party.
 
We will not dwell on the impact redistricting could have on the makeup of the House. Regarding retirements, out of the 221 Democrats currently in the House, to date 25 have announced their retirement or intention to run for another office: four are running for the Senate; one for governor; one for attorney general; and one, U.S. Rep. Karen Bass (D-Calif.), is running for Mayor of Los Angeles. There are currently 213 Republicans in the House and 12 are planning to retire or run for another office: four are running for the Senate (three of which for the open Missouri Senate seat), one for governor, one for attorney general and one for Secretary of State.
In the Senate, which is divided 50-50, four senators have announced retirements: three Republicans from Missouri, Pennsylvania and North Carolina, and one Democrat from Vermont.
 
The year of 2022 both legislatively and politically will not be dull.

State Medicaid Updates
 
At the start of 2022, several states are considering Medicaid expansion either on the ballot or within their legislatures. Measures by the Biden Administration have also led some states to modify their expanded Medicaid programs.
 
In November, voters in South Dakota [ [link removed] ] will have the option of joining a handful of other red states that have used the ballot to expand Medicaid eligibility to individuals who earn up to 138% of the federal poverty level. Similar referendums have proven to be popular in other states, but voters wishing to see expansion enacted in South Dakota may face additional hurdles. Republicans in the state are sponsoring a separate referendum in the June primary that would require any new constitutional measures to obtain 60% voter approval if it would increase taxes or cost the state at least $10 million. Among the six states that have passed similar initiatives, 60% voter approval was only achieved in Idaho.
 
North Carolina [ [link removed] ] recently formed a legislative committee to examine “ways in which access to health care and health insurance can be improved," and Medicaid expansion is expected to be among the topics examined by the committee.
 
The Medicaid programs in Arkansas [ [link removed] ] and Montana [ [link removed] ] will no longer be permitted to charge enhanced premiums from enrollees who received coverage under expanded Medicaid programs. In late December, the Biden administration rejected waiver requests from both states that have would have allowed the state to continue charging premiums on the grounds that premiums present a barrier to coverage. The states will be permitted to charge premiums until the end of 2022. In Montana, the state may continue to charge premiums that equal 2% of an enrollee’s income.
 
Finally, the Biden administration rejected a waiver request from Georgia [ [link removed] ] that sought to implement a work requirement under a limited Medicaid expansion in that state. The decision was not surprising given the administration’s stated intent to withdraw the previous administration’s approval [ [link removed] ] of work requirements.

New York Passes Legislation Requiring Co-prescribing of Opioid Antagonist
 
On Dec. 30, 2021, New York Gov. Kathy Hochul (D) signed legislation [ [link removed] ] that requires prescribers to issue a prescription for an opioid antagonist when prescribing opioids under certain circumstances. Under the new law, prescribers must issue a prescription for an opioid antagonist when issuing the first prescription for an opioid to a patient during that calendar year, when that patient has a history of substance use disorder, exceeds specified dosage amounts or has a concurrent use of opioids and benzodiazepine or nonbenzodiazepine sedative hypnotics. The bill exempts prescriptions issued for patients under care at a general hospital, nursing home or hospice.
 
Similar legislation passed in neighboring New Jersey [ [link removed] ] in 2021, and at least seven additional states require co-prescribing.

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
 • Provider Relief Fund Reporting portal [ [link removed] ]
 • ADEA memo [ [link removed] ] regarding vaccines at the state level
 • 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] ] .

ADEA State Calendar [ [link removed] ]

ADEA Washington Calendar [ [link removed] ]

ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [link removed] ]

Key Federal Issues [ [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.
 
©2021
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 and Advocacy
 
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
 
Brian Robinson
ADEA Program Manager for Advocacy and Government Relations
 
[email protected] [ [link removed] ]

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