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American Dental Education Association


Volume 2, No. 90, March 7, 2023

Supreme Court Hears Challenges to Biden’s Student Loan Debt Relief Plan
 
Last week, the Supreme Court heard oral arguments in Biden v. Nebraska [ [link removed] ] and Department of Education v. Brown [ [link removed] ] . Both cases challenged the Biden administration’s student loan debt relief plan. The Biden administration based its decision to cancel student loans on the HEROES Act, which was passed in 2001, in the wake of the Sept. 11 terrorist attacks. The Act grants the Secretary of Education the power to “waive or modify” a federal student loan program in order to ensure that individuals “are not placed in a worse position financially” because of “a war or other military operation or national emergency.” The administration argues that the COVID-19 pandemic was a national emergency and that the Secretary exercised his power to “waive or modify” student loan repayment.
 
If the Biden administration succeeds in these cases, it is estimated that 43 million Americans could benefit from the program.
 
However, the majority of the justices seemed to doubt the administration's argument that the HEROES Act, which the administration cites as the basis for its decision to cancel student loans, use of the words “waive or modify” provides the administration the authority needed to make decisions regarding student loan debt cancellation. Chief Justice John Roberts and Justice Clarence Thomas noted that “waive or modify” does not mean cancellation. While Justice Brett Kavanaugh noted that Congress could have used the words “student loan cancellation” or “student loan forgiveness” in the Act but they did not.
 
The three liberal justices—Justices Sonia Sotomayor, Elena Kagan and Ketanji Brown-Jackson—echoed the administration’s argument that the HEROES Act provided the necessary authority for the administration to cancel student loan debt.
 
A decision in the case is expected by June 2023. The Biden administration has said that payments will resume 60 days after the Supreme Court decision or at the end of August, whichever comes first.

CMS Releases Additional Guidance on PHE Transitions
 
The Centers for Medicare & Medicaid Services (CMS) released a Public Health Emergency’s (PHE) transition, waivers and flexibilities fact sheet [ [link removed] ] as part of the Biden administration’s efforts to provide ongoing guidance to the public, state and local governments; health care professionals; and private insurers as the PHE comes to an end.
 
The fact sheet provides guidance on:
 • COVID-19 vaccines, testing and treatments;
 • Telehealth services;
 • Health care access (continuing flexibilities for health care professionals); and
 • Inpatient hospital care at home (expanded hospital capacity by providing inpatient care in a patient’s home).

As the fact sheet notes, it does not cover every scenario, but it does provide a very good overview and gives solid advice on what to expect moving forward.

IDR Student Loan Account Adjustment Date Pushed Back
 
In late 2022, the Department of Education (ED) announced proposed regulations that would make it easier for borrowers to have their federal student loans forgiven under an income-driven repayment program (IDR). Soon after the proposed regulations were released, ED also announced a one-time-only adjustment to borrowers’ accounts that would address past inaccuracies and thereby align all IDR accounts with the proposed IDR-tracking procedures going forward.
 
Based on the newly eligible months from the one-time account adjustment, borrowers who have reached 240 or 300 months’ (as applicable) worth of payments for IDR forgiveness would see their federal student loans forgiven by July 2023.
 
However, ED recently released a statement [ [link removed] ] noting that the account adjustments would not be completed until the summer of 2023. This effectively pushes back the date by which those who qualify will have their federal student loans forgiven.

North Carolina House and Senate Reach Deal on Medicaid Expansion
 
Earlier this month, the North Carolina House of Representatives passed a bill [ [link removed] ] to expand Medicaid to include individuals who earn up to 138% of the federal poverty level. Although there was broad support for the measure in both chambers of the General Assembly, there was disagreement among the leadership of the House and Senate regarding the inclusion of measures that would reform certificate of need laws and grant increased autonomy to nurse practitioners.
 
On March 2, leaders of the General Assembly announced [ [link removed] ] that they had reached a deal regarding the provisions over which they disagreed. Although a Senate vote isn’t expected until later this month, the final legislation will likely include some certificate of need reform and will not include increased autonomy for nurse practitioners.
 
The state’s Department of Health and Human Services has estimated that the expansion of Medicaid could provide coverage for up to 300,000 people.

Some States to Begin Medicaid and CHIP Disenrollment in April
 
For nearly three years, states have been required to provide continuous enrollment in Medicaid and Children’s Health Insurance Program (CHIP) in exchange for enhanced federal funding. But beginning April 1, states will be permitted to begin disenrolling individuals from their state Medicaid programs.
 
The required Medicaid and CHIP continuous enrollment policy was initially enacted in March 2020 as a response to the COVID-19 pandemic under the Families First Coronavirus Response Act [ [link removed] ] , but over the next year, states will again be required to verify the eligibility of individuals enrolled in Medicaid. Guidelines [ [link removed] ] issued by the Centers for Medicare & Medicaid Services grant states up to 12 months to initiate—and 14 months to complete—a renewal for all individuals enrolled in Medicaid. Additionally, over the next nine months, enhanced federal funds provided as part of a state’s Federal Medicaid Assistance Percentage (FMAP) will begin to phase down [ [link removed] ] . The current increase of 6.2% will be reduced to 5% until June 2023, 2.5% until September 2023 and 1.5% until December 2023.
 
While disenrollment plans will vary from state to state, at least 44 states have publicly posted their plans [ [link removed] ] or at least a summary of their plans. While disenrollment is permitted to begin in April, some states won’t begin until May, June or July. Among the states that will begin [ [link removed] ] in April are Arizona, Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma and West Virginia.
 
It's been estimated that between 5 – 14 million people will lose coverage once disenrollment begins. Some individuals who are disenrolled may be eligible for enrollment through an Affordable Care Act Marketplace [ [link removed] ] . Between March 31, 2024, and July 31, 2024, a special enrollment period will open for people who are disenrolled from Medicaid. People who are disenrolled will have up to 60 days to enroll in a marketplace plan after losing coverage.

Advocate to go on Brief Hiatus
The ADEA Advocate will not publish next week. The AGR staff will be in Portland, OR for the 2023 ADEA Annual Session & Exhibition from March 11-14. If you need an advocacy update look us up in Portland and we will provide one in-person!

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
 • Applications open [ [link removed] ] for Ryan White Part F Dental Reimbursement Program
 • Applications open [ [link removed] ] for HRSA Dental Public Health Research Fellowship
 • 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] ] .

Key Federal Issues [ [link removed] ]

ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [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.
 
©2023
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
Tel: 202-289-7201
Website: www.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
 
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