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Volume 1, No. 42, December 10, 2019

Secretary DeVos Wants the Federal Student Aid Office to be Stand-alone, Independent Agency
 
Last week, U.S. Secretary of Education Betsy DeVos delivered a major speech [ [link removed] ] at the Annual Federal Student Aid Training Conference. DeVos proposed that the Office of Federal Student Aid (FSA) become an independent, stand-alone agency. However, establishing this office as such would require an act of the U.S. Congress. As a stand-alone independent agency, FSA would not report to the Department of Education, and Members of Congress would have limited oversight authority. FSA currently manages $1.5 trillion in federal student loans.
 
DeVos has been vocal about her concern with FSA. She believes that the many individually administered repayment programs are an unmanageable and confusing patchwork, which increase the Department’s administrative costs.
 
The issue of streamlining the student loan repayment programs was addressed in the College Affordability Act, the bill that reauthorizes the Higher Education Act. This bill was recently passed by the U.S. House of Representatives’ Education and Labor Committee. However, it is unclear when House Speaker Nancy Pelosi (D-CA) will bring the bill to the floor for a vote.

Maine to Examine Ending Dental Waiting Periods for Children
 
A bill recently pre-filed in the Maine State Legislature would end coverage waiting periods for recently insured children. According to the Portland Press Herald [ [link removed] ] , though dental insurance usually provides immediate coverage for preventative care, many plans require a waiting period before coverage is provided for caries treatment or other dental procedures. In some cases, waiting periods can be as long as a year. Waiting periods are usually implemented to prevent people from buying coverage when dental treatment is needed—and then dropping the coverage after treatment has been provided.
 
The Maine legislature will reconvene in January.

CMS Opens Comment Period on Tennessee Block Grant Proposal
 
On Dec. 2, the Centers for Medicaid & Medicare Services (CMS) opened a comment [ [link removed] ] period on Tennessee’s Medicaid block grant proposal. As covered in the Oct. 1 edition of the ADEA Advocate, the proposal would shift Medicaid funding in Tennessee from an open-ended arrangement under which the federal government pays a percentage of the state’s Medicaid costs based on per-capita income, to an arrangement where the federal government provides a fixed amount of funding annually. The state submitted a 60-page proposal [ [link removed] ] to CMS that calls for a modified version of a traditional block grant that, if approved, would require the federal government to provide additional funds during times of growth in Medicaid enrollment. In exchange for accepting fixed funding, the state would have fewer restrictions in the way it is required to spend Medicaid dollars, which the state claims would lead to cost savings and innovation. According to the proposal, if Tennessee can save funds under the block grant, the difference between the amount spent and the fixed block grant would be split in half between the state and the federal government.
 
In its proposal, the state claims that the funding arrangement will not lead to disenrollment or reductions in benefits. The state would also continue to cover Early and Periodic Screening, Diagnostic and Treatment [ [link removed] ] requirements, which include dental benefits for enrollees under the age of 21. Further, the state claims that savings could be used to add dental benefits for prenatal and postpartum women.
 
Despite these assurances, critics [ [link removed] ] of the proposal are not convinced the state would avoid cuts to services. As noted in a recent analysis [ [link removed] ] from Health Affairs, the state’s requests for flexibility include an exemption from all minimum coverage requirements, and the ability to impose a 12-month lockout period for undefined “member fraud.” Others have also claimed the ability to keep any money saved under the block grant creates an incentive for the state to keep enrollment low [ [link removed] ] .
 
If the proposal is approved, Tennessee would be the first state to receive funding under a block grant. CMS will accept comments until Dec. 27.

“Short-term” Health Plans Pose Risk for Consumers
 
Last year, the Trump administration expanded access to “short-term” health insurance plans [ [link removed] ] that are not required to provide all the benefit coverage mandated under the Affordable Care Act, unlike insurance plans in health exchanges. Short-term plans were initially designed to provide “stopgap” coverage for individuals transitioning between jobs or between health plans. Because of their transitional nature and limited benefit coverage, these plans’ coverage periods were limited to no more than three months.
 
However, the Trump administration extended the coverage period for short-term plans from three months to one year, effectively making them long-term plans. Though the costs of these plans tend to be much lower than plans on federal and state health exchanges, these plans put consumers at a much higher risk for large, out-of-pocket expenses and limits consumers' access to care due to the limited benefit coverage. In The New York Times, JoAnn Volk, a research professor with the Center on Health Insurance Reforms at Georgetown University, called the health insurance landscape outside of the health exchanges the “Wild West [ [link removed] ] ,” because many consumers do not fully understand that short-term plans do not provide them with the same level of coverage as health insurance plans purchased through the health exchanges.

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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