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ADA advocacy measure for measure

August 11, 2014

By Craig Palmer

Washington – For full measure of Association legislative and regulatory advocacy consider recent ADA Council on Government Affairs and American Dental Political Action Committee communications. Both draw on energy generated by grassroots advocates at the May 19-21 ADA Washington Leadership Conference and both inspired pass-it-along messaging.

Consider, too, the letters, reports, statements, testimony and other written communications with lawmakers, regulators and print and online media as expressions of Association advocacy but also the Association's increased advocacy engagement with social media as described in a report prepared for the Council on Government Affairs Aug. 21-23 meeting. The ADA Facebook page has more than 110,000 followers.

Consider the proliferation of Association online media venues replete with messages advocating for oral health, including but by no means limited to the advocacy home page, a web page featuring recent advocacy tweets and links to other ADA advocacy sites including Action for Dental Health: Dentists Making a Difference and the ADA Engage Legislative Action Center.

Consider the Association's invitation to "become an advocate." Consider your oral health advocacy as you take measure of Association advocacy. "You can make a critical difference," said an ADA member service center email. "With the ADA, it's easy to get involved. Get on the Action E-List today."

Consider the messengers but first the message.

July 21 "Recent ADA Legislative and Regulatory Advocacy" email to Council on Government Affairs
 
"CGA members, I know you're all aware of these initiatives because they've been vetted by the council or by council leadership but sometimes it's helpful to see it all in one place," said the email from Thomas Spangler, ADA senior director for legislative and regulatory policy. "Since the WLC concluded on May 21, the ADA has been actively engaged in a wide range of legislative and regulatory activities that affect dentistry."

CGA members characterized that message as a "great synopsis of where we are on the different issues" and "very helpful in explaining advocacy measures at the national level" and said, "I passed it on" and "will pass this along" to their state dental societies.

The July 21 CGA message measures Association advocacy with 15 policy statements.

Business and tax issues

The ADA offered support for H.R. 2542, the bipartisan Regulatory Flexibility Improvements Act of 2013 to ensure that all federal agencies appropriately consider the impact of their rules on small businesses across America.

The ADA joined a coalition representing businesses in every state in strongly supporting H.R. 4457, America's Small Business Tax Relief Act of 2014. This legislation would restore the small business expensing — Section 179 expensing — level to $500,000 and permanently index the level to inflation. Legislation expanding and/or extending small business expensing has been enacted eight times across two presidential administrations and six Congresses under both Democratic and Republican leadership.  These higher expensing limits were temporary, however, and beginning in 2014 they reverted back to $25,000 and will remain there unless Congress acts.

The ADA supports continued use of the cash method of accounting for service industries of all size and urges opposition to any tax proposal that would force businesses currently allowed to use the cash method to switch to accrual accounting.

The ADA signed on to a Family Business Coalition letter supporting full repeal of the estate tax and requesting that the House of Representatives pass the Death Tax Repeal Act, H.R. 2429, this year. The bill has more than 220 bipartisan cosponsors. The letter is addressed to House leadership.

Medicaid RAC Audits

On behalf of the ADA, on July 9, Dr. Jessica Meeske, a pediatric dentist from Nebraska, participated in a Senate Special Committee on Aging roundtable discussion. She addressed problems associated with the Medicaid RAC audits in Nebraska. RAC audits were established pursuant to the Affordable Care Act and the ADA believes they lack requisite transparency and fairness.

A letter to the chair of the National Governors Association's health and human services committee asks for the governors' support in changing the way in which Medicaid audits are conducted. The ADA would prefer administrative changes that would foster an environment of cooperation and education rather than punitive burdens that could discourage participation.

Dentist/Rep. Paul Gosar's, R-Ariz., letter to the Centers for Medicare & Medicaid Services supporting the ADA request was signed by 74 bipartisan members of Congress. The Association is pursuing a Senate "Dear Colleague" letter.

Medicare Part D and other Fraud and Abuse Regulations

An ADA letter to the House Small Business Committee chair and ranking Democrat asked them to ask the Department of Health and Human Services to postpone implementation of this Medicare rule until a cost study is conducted as required by law. A June 16 ADA news article, which was also posted at ADA.org, explains that dentists treating Medicare beneficiaries must enroll in the program or opt out in order to prescribe medication to their qualifying patients with Part D drug plans.

ADA filed comments on a proposed rule from the HHS Office of the Inspector General concerning Medicare and state health care programs. The OIG proposed revisions to civil monetary penalty rules.


GME Funding

Organized Dentistry Coalition members, including the Association, supported a letter to the Health Resources and Services Administration objecting to the potential elimination of children's hospital graduate medical education funding for FY 2015. The ADA was scheduled for a follow-up meeting with HRSA officials in August on this matter.

Smokeless Tobacco

The ADA joined the American Cancer Society, American Heart Association, American Lung Association, American Medical Association, Campaign for Tobacco-Free Kids, Legacy, Oral Health America and the Robert Wood Johnson Foundation on a letter to Major League Baseball asking Commissioner Selig to honor Tony Gwynn's memory by agreeing to a complete prohibition on tobacco use at ballparks and on camera.

Indian Health Service

The ADA joined the American Academy of Pediatrics, American Association of Colleges of Osteopathic Medicine, American Association of Colleges of Pharmacy, American Congress of Obstetricians and Gynecologists, American Psychological Association and others on a letter to the National Institutes of Health asking the NIH to establish American Indian/Alaska Native Research Coordinator and Liaison positions.

Nutrition and Wellness

The ADA filed comments on a proposed Food and Drug Administration rule governing Nutrition and Supplement Facts Labels for conventional foods and dietary supplements.

The Association filed comments on the Food and Nutrition Service's proposed rule governing the content of school wellness policies required for local educational agencies participating in the National School Lunch Program and/or the School Breakfast Program.

Disaster Preparedness

The ADA sent a letter to Senate leaders supporting S. 2196, the Good Samaritan Health Professionals Act of 2014. This bill would limit the liability of volunteer health care professionals for the good faith treatment of disaster victims during a mass casualty event.

July 30 "2014 WLC Advocacy Accomplishments" email to ADA members

"ADPAC would like to share with all of you the impact that your colleagues made on Capitol Hill during the Washington Leadership Conference," said the "Dear Colleague" email from Dr. Ken McDougall, ADPAC chair. "Although Congress is currently gridlocked on many issues, ADA, with the support of member dentists, decided to strategically advocate on issues that are both important to the profession and have a chance of being acted upon by this Congress."

Dr. McDougall's message includes a summary of dentists running for Congress in November and links to a Washington Leadership Conference video at ADA.org/WLC and other advocacy information. ADPAC's e-message cited gains in congressional support for these ADA-backed measures after grassroots dental leaders canvassed Capitol Hill during the May 19-21 WLC.

California's Tri-County Dental Society plans to reprint the ADPAC email in its newsletter publication for 1,800 member dentists, according to an ADPAC staffer.   

Student Loan Interest Deduction Act of 2013 (H.R. 1527)
 
This bill would help ease the burden of student loan debt by significantly increasing the deduction allowed for student loan interest and allowing the deduction regardless of income. H.R. 1527 would increase the current $2,500 deduction ceiling to $5,000 for individuals and $10,000 for a joint return. Since the WLC, 14 new co-sponsors have signed onto the bill bringing the total to 43.

Federal Student Loan Refinancing Act (S. 1066)
This legislation would help ease the debt burden by enabling consolidation or refinancing of Direct Unsubsidized Stafford Loans (and/or Federal Direct Consolidation Loans) for dental school graduates at a fixed rate of 4.0 percent. It would apply retroactively to all such loans taken out between July 1, 2006, and the law's effective date. Since the WLC, the bill has added four Senate co–sponsors for a total of 10.

Action for Dental Health Act of 2014 (H.R. 4395)
This legislation supports expansion of ongoing programs that make it feasible for many more private sector dentists to care for the underserved. Dentists created momentum for the bill, which has 41 co-sponsors. This legislation was introduced in coordination with the launch of the Action for Dental Health Report to Congress. The Association is seeking Senate support for companion legislation.

Dentists in Congressional Races
Incumbent Rep. Mike Simpson, R-Idaho, won one of the most-watched competitive primaries in this election cycle with 62 percent of the vote. This is considered to be a safe Republican seat but he will face an opponent in the general election.

Dr. Brian Babin, R-Woodville, won Texas' 36th district primary run-off election 59%-41%. This is also considered to be a safe Republican seat but he will face an opponent in the general election.

Incumbent Rep. Paul Gosar, R-Ariz., will not have an opponent in the Aug. 26 Republican primary but will have an opponent in the general election.