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American Dental Education Association
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Volume 1, No. 44, January 14, 2020

ADEA’s Summary of State and Federal Loan Forgiveness Programs Updated
 
ADEA’s Annual Summary [ [link removed] ] of State and Federal Student Loan Repayment and Forgiveness Programs for oral health professionals has been updated for the new year and is now available on ADEA’s website. The summary includes information on state-sponsored loan forgiveness programs, states participating in the Health Resources and Services Administration’s (HRSA) state loan repayment program and states participating in the HRSA National Health Service Corps loan repayment program and other federal programs. A complete list of HRSA loan repayment and scholarship programs available to dental and dental hygiene students and faculty may be found on the HRSA website [ [link removed] ] .

2020 State Legislative Sessions Set to Begin
 
January marks the traditional convening of many state legislatures throughout the country. Most state legislatures, unlike Congress, only meet part-time and only for a portion of the year. With 35 state legislatures set to begin session in January, and only 12 expected to meet beyond May, ADEA is anticipating considerable state activity over the coming months.
 
Many of the issues that were trending in 2019 will likely continue to be hot topics for states in 2020. Legislation already filed in legislatures throughout the country address topics like licensure portability [ [link removed] ] , initial licensure exams [ [link removed] ] , opioid prescribing [ [link removed] ] practices, scope of practice [ [link removed] ] and Medicaid coverage [ [link removed] ] for dental services. ADEA will monitor these issues and many others throughout the year.
 
The ADEA Advocate will continue to provide weekly updates on major legislative activity, and ADEA’s U.S. Interactive Legislative and Regulatory Tracking Map [ [link removed] ] will be updated daily to help you stay current on legislative and regulatory activity in your state.

Several States Pursue Medicaid Expansion and Work Requirements
 
On Dec. 23, the Centers for Medicare & Medicaid Services (CMS) approved Utah’s request to implement full Medicaid expansion [ [link removed] ] under the Affordable Care Act. The approval will allow Utah to expand Medicaid coverage to individuals who earn incomes up to 138% of the federal poverty level (FPL) and will include work requirements for most adult beneficiaries.
 
Regular readers of the ADEA Advocate may recall that Utah has already implemented partial Medicaid expansion that provides coverage to individuals who earn up to 100% of the FPL, but that the federal government also announced [ [link removed] ] it would not approve enhanced federal funding for expansion populations under a partial expansion plan. As a result of the enhanced funding rejection, state law required Utah officials to pursue a fallback plan [ [link removed] ] , that included seeking approval for full Medicaid expansion with work requirements. CMS is still reviewing other aspects of Utah’s waiver request approval that includes enhanced premiums for people who make more than 100% of the federal poverty level.
 
Early in December, South Carolina [ [link removed] ] was granted approval to implement work requirements for its Medicaid population. Under the plan, most able-bodied adults would be required to work or engage in volunteer activity for at least 80 hours per month. While CMS has approved work requirements for 10 states, federal courts have struck down [ [link removed] ] the requirements in three states. Two other states—Arizona [ [link removed] ] and Indiana [ [link removed] ] —have suspended work requirements in the wake of the court rulings. While the court cases are being reviewed in a federal court of appeals, at least one of the states appealing the ruling, Kentucky [ [link removed] ] , has pulled out of the lawsuit.
 
On Jan. 9, Kansas Gov. Laura Kelly (D) and Kansas Senate Majority Leader Jim Denning (R) announced [ [link removed] ] that they had reached an agreement to pass Medicaid expansion legislation in the state. Under the plan, the state will expand Medicaid coverage to individuals and families who earn up to 138% of the FPL. The plan does not include a work requirement, as pushed for by some Republican members of the legislature, but it does include a surcharge on hospitals to help pay new costs.

FDA Bans Some—But Not All—Flavored-nicotine Vaping Products
 
The U.S. Food and Drug Administration (FDA) issued its final rule [ [link removed] ] last week regulating certain flavors of nicotine vaping products in an attempt to curb teen use. The rule was the Trump administration’s [ [link removed] ] response to last year’s spike in deaths caused by e-cigarettes and vaping products.
 
Under the new rule, which takes effect in 30 days, companies that do not stop the distribution of the sweeter flavors that appeal to kids risk enforcement action. Companies are also at risk of regulatory action if their products target kids or if they fail to take adequate measures to prevent access to children. However, they will still be able to sell tobacco and menthol-flavored pods for adults who use the products to quit smoking.
 
The rule tries to appease both sides of the vaping debate—on one side the parents, anti-smoking advocates and health professionals who are all concerned about these products’ health impact and, on the other, the vaping stores, tobacco companies and adults who are trying to quit smoking who are all focused on consumers having access to the products. This was echoed in U.S. Secretary of Health and Human Services Alex Azar’s comment, “by prioritizing enforcement against the products that are most widely used by children, our action today seeks to strike the right public health balance by maintaining e-cigarettes as a potential off-ramp for adults using combustible tobacco while ensuring these products don’t provide an on-ramp to nicotine addiction for our youth.”
 
The American Medical Association and other health advocates noted that the rule was not enough but was instead a “good first step.”

Poll Finds Most Voters View Health Care As Top Issue For 2020 Presidential Election
 
The Morning Consult for the Bipartisan Policy Center released an issue poll [ [link removed] ] last week showing that 56% of registered voters nationwide listed health care among their top three issues for the upcoming presidential election. The economy came in second at 44% overall. This is newsworthy because most often the economy is the leading voter concern during presidential elections. If these findings are consistent across other polls, we might expect Congress to come together and agree on some health care legislation. The most likely issues to be resolved are those that the U.S. House of Representatives and Senate committees were working on during 2019: reducing prescription drug costs and ending surprise medical bills (balance billing).
 
This poll was somewhat unique because it asked the same questions of voters in Iowa, New Hampshire and South Carolina as it did of voters nationwide. In those three states, health care also received the most concern from registered voters, representing 59%, 60% and 56% of those polled in Iowa, New Hampshire and South Carolina, respectively.
 
In general, voters wanted to fix the current system and did not favor repeal and replacement of the Affordable Care Act or turning to a Medicare-for-all system.

Democrats Plan Effort to Overturn DeVos’ Borrowers’ Defense Rule
 
This week, Democrats in the U.S. House of Representatives plan to vote on H.J. Res. 76, the Overturn Student Loan Rule [ [link removed] ] , which would overturn changes to the borrowers’ defense regulations promulgated by U.S. Secretary of Education Betsy DeVos. The new regulations are set to go into effect on July 1, 2020. These new regulations would:
 • Eliminate automatic loan discharge for students who attended schools that closed if the students did not enroll in another institution within three years,
 • Require borrowers to apply for loan discharge individually instead of allowing automatic discharges for groups of students,
 • Establish a three-year statute of limitation on claims and
 • Eliminate the prohibition on predispute arbitration.

The 2015 collapse of the for-profit Corinthian Colleges, followed by the closure of the for-profit ITT Tech in 2016, triggered an onslaught of loan forgiveness applications under the borrowers’ defense rule.
 
The U.S. Department of Education contends that the new regulations would save the federal government $11 billion and simply “corrects the wrongs” of the prior administration [ [link removed] ] . However, Democrats and student groups believe that the new regulations are unfair [ [link removed] ] because they limit the ability of borrowers who were defrauded by schools or harmed by their school’s closure to have their loans forgiven.
 
The Congressional Review Act, passed in 1996, gives Congress the right to nullify a rule using a joint resolution, which must be introduced within 60 legislative days of the finalized regulatory action. Though the resolution will pass the House, it will likely not pass the Republican-controlled Senate and would be vetoed by President Trump even if the resolution were to successfully clear the Senate.

Attention, dental and craniofacial researchers, oral health advocates, dental educators, students, residents and fellows:
Join the American Association for Dental Research (AADR), the American Dental Education Association (ADEA) and the Friends of National Institute of Dental and Craniofacial Research (FNIDCR) on Tuesday, March 17, 2020, for the 2020 AADR, ADEA and FNIDCR Capitol Hill Day [ [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.
 
©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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