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American Dental Education Association
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Volume 1, No. 41, December 3, 2019

Obamacare Initial Enrollment Numbers Decline
 
Obamacare enrollment on the federal health insurance marketplace declined by 20% [ [link removed] ] in the first two weeks of this year’s open enrollment compared with last year. This year, at least 100,000 fewer people signed up for insurance on the first day of enrollment and the decline continued days after. In the first nine days of open enrollment, 932,049 people chose a plan for the 2020 coverage year on HealthCare.gov. That compares with 1,176,232 consumers who selected their coverage through the exchange during the first two weeks last year, according to federal data.
 
Democrats [ [link removed] ] are pointing to technical problems experienced by the HealthCare.gov website on the first day of open enrollment as one reason for the lower numbers, and they are pressing the Trump administration for answers regarding if these technical problems have been fixed.
 
The elimination of the individual mandate also continues to impact enrollment. This is the second enrollment season since the U.S. Congress eliminated Obamacare’s individual mandate fee. The mandate imposed a tax penalty on consumers who went uninsured and was a key part of the health care law.
 
Finally, the uncertainty surrounding the constitutionality of Obamacare is also believed to impact enrollment. The Fifth Circuit Court of Appeals could rule any day now on the constitutionality of Obamacare, though U.S. Secretary of the Department of Health and Human Services Alex Azar has said that regardless of the ruling, open enrollment will continue since the Trump administration will likely seek a stay in the case while deciding how to respond.

Wisconsin Governor Signs Bill Expanding Eligibility for Health Professional Loan Repayment Program
 
On Sept. 25, Wisconsin Gov. Tony Evers (D) signed a bill [ [link removed] ] that expanded eligibility under the state’s Physician and Dentist Loan Assistance Program and the Health Care Provider Loan Assistance Program. With passage of the bill, dentists and dental hygienists who work in free or charitable clinics will now be eligible to apply for education loan repayment assistance. Before the passage of the bill, only dentists and hygienists who worked in rural or dental health shortage areas were eligible for assistance. The program provides up to $50,000 for dentists who agree to work in an “eligible practice area” for three years, and up to $25,000 for hygienists who commit to a three-year service obligation.
 
For more information about this program and similar programs in other states, please refer to ADEA’s summary of State and Federal Loan Forgiveness Programs [ [link removed] ] .

U.S. House Committee Restricts Access to Tobacco Products Due to Vaping Crisis
 
Last month, the U.S. House of Representatives’ Energy and Commerce Committee advanced H.R. 2339, Reversing the Youth Tobacco Epidemic Act of 2019. This Democratic sponsored measure would ban all flavored tobacco products [ [link removed] ] including menthol cigarettes, raise the purchasing age to 21 nationwide for all tobacco products and ban online sales in a bid to curb tobacco use. The bill passed by a 28 to 24 vote and now moves to the House floor for a final vote and passage.
 
There were splits in both parties on this bill, with two Republicans joining Democrats in supporting the bill and three Democrats voting against the bill. Republican critics of the bill warned that the bill will not impact vaping, but would limit adult options to either curb or end their addiction to nicotine. The bill’s ban on menthol cigarettes also raised the ire of some Congressional Black Caucus members who opposed the bill on the grounds that the ban could have unintended consequences for black communities who disproportionally buy menthol cigarettes and who do not have as many smoking cessation programs available to them as other communities do. These Members of Congress see the ban as being “unfair and discriminatory,” and urged their colleagues to exempt menthol from the ban. However, the committee’s Democratic leadership stressed that the bill’s ban is intended to punish industry players that sell prohibited products rather than consumers.
 
However, the bill is expected to die in the U.S. Senate where U.S. Sen. Mitch McConnell (R-KY) has introduced S. 1541, Tobacco-Free Youth Act [ [link removed] ] , which would raise the purchasing age for tobacco products, including e-cigarettes, to 21 nationwide, but unlike the House bill, it would not place any other restriction on tobacco sales. The Senate will likely pass McConnell’s bill and not the House’s. The two chambers will have to reach a compromise if they are to produce a final bill addressing the tobacco and vaping crisis.
 
Recently, advancing H.R. 2339 and S. 1541 took on a new sense of urgency since the Trump administration’s efforts to ban flavored tobacco products have stalled. The administration is currently discussing the possibility of exempting menthol cigarettes from its ban as well as carving out age-restricted vape shops, but to date, no new regulations have been released.

Washington, DC Proposes Changes to Continuing Education Requirements for Teachers’ Licenses in Dentistry and Dental Hygiene
 
On Nov. 22, the District of Columbia Department of Health released proposed regulatory changes [ [link removed] ] to continuing education requirements for teachers’ licenses in dentistry and dental hygiene. The proposed changes would reduce the amount of required ethics courses from two hours to one hour, and would also require that at least 10% of required continuing education (CE) hours address public health priorities as determined by the Director of the DC Department of Health. The proposal would also allow 50% of CE hours to be completed through online courses for both categories of licenses.
 
Comments are due within 30 days of the Nov. 22 notice, and should be sent to the DC Department of Health, Phillip L. Husband, General Counsel, Office of the General Counsel, 899 North Capitol Street, N.E., 6th Floor, Washington, D.C. 20002.

Funding Bills Ready to Move Forward
 
On Nov. 23, the Chairs of the U.S. House of Representatives and Senate Committees on Appropriations took a necessary and important first step toward completing the bills funding the government for fiscal year (FY) 2020, which began on Oct. 1. U.S. Rep. Nita Lowey (D-NY) and U.S. Sen. Richard Shelby (R-AL) reached an agreement on the funding allocations for each of the 12 subcommittees for the fiscal year. This will allow Members of Congress and their staff to reach final agreement on each of the appropriations bills, hopefully before the current funding extension expires on Friday, Dec. 20.
 
The details and the individual subcommittee allocations remain closely held in order to permit the Members to come to closure without outside interference. The Oral Health Training Programs were funded in both the House and Senate bills at the $40.7 million level that ADEA and its dental community partners requested. Both Houses provided an increase for the National Institute of Dental and Craniofacial Research; the House bill provides $484.4 million and the Senate $486.8 million—both allocations are approximately a 5% increase over FY 2019.
 
Both Houses must compromise to overcome remaining obstacles to the passage of these bills, but the way has been cleared to reach those agreements. The ADEA Advocate will report to you on the progress in the upcoming weeks.

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.
 
©2019
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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