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Appropriators bar alternative provider funds

June 26, 2015

By Craig Palmer

Washington – House and Senate appropriation bills would continue a long-standing prohibition on funding for alternative dental health care providers demonstration projects authorized by the Affordable Care Act.

The ACA authorizes grants "to establish a demonstration program to establish training programs to train, or to employ, alternative dental health care providers in order to increase access to dental health care services in rural and other underserved communities." But Congress has never appropriated funds to support the 15 authorized demonstration projects.

The ACA defines alternative health care providers to include "community dental health coordinators, advance practice dental hygienists, independent dental hygienists, supervised dental hygienists, primary care physicians, dental therapists, dental health aides and any other health professional that the Secretary [Department of Health and Human Services] determines appropriate."

Congress also included in the alternative provider section of the ACA a "clarification regarding [the] dental health aide program" authorized by the Affordable Care Act: "Nothing in this section shall prohibit a dental health aide training program approved by the Indian Health Service from being eligible for a grant under this section."

The alternative dental health care providers authorizing language is still in effect after the U.S. Supreme Court June 25 upheld an unrelated key part of the Affordable Care Act providing health insurance subsidies for qualifying Americans.

But both the House and Senate Appropriation Committees have approved bills that would continue to bar funding for these demonstration projects during fiscal year 2016, which begins Oct. 1. If an appropriations ban is to continue Congress must renew it annually. The FY 2015 appropriation bars such spending.

The Senate Appropriations Committee approved a Department of Health and Human Services appropriation continuing the ban on ACA demonstration project spending during FY 2016 the same day the Supreme Court upheld the Affordable Care Act.

"The Committee continues long-standing bill language that prohibits funding for section 340G-1 [demonstration program] of the PHS [Public Health Service] Act," said Senate Committee Report 114-74 on the appropriation for government health programs, including those authorized by the Affordable Care Act. House appropriation language is the same.

Both chambers have approved language barring alternative provider funding in FY 2016 but neither chamber has acted on the committee-approved appropriation bills.