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Association presses Medicaid, access issues in Senate health reform debate

Washington—The Association offered dental Medicaid and other "suggestions, support and concerns" as Senate leaders prepared for historic health care reform debate.

The Association has not endorsed any of the health care reform bills in the House of Representatives or Senate but has advocated for an oral health agenda as Congress debates health policy.

"While the ADA believes that the current oral health care system works well for the majority of Americans, we also recognize that more needs to be done to ensure good oral health outcomes for underserved populations," Association officials told Senate leaders in a wide-ranging health policy letter.

Although the Association has advocated an oral health agenda throughout the current health policy debate in frequent communications with members of Congress and congressional leaders, the Nov. 17 letter is the most comprehensive policy communication with the U.S. Senate.

The letter was directed to Senate leaders who have taken the lead on health reform legislation in that chamber and would likely have key roles in negotiations to resolve any differences between House and Senate health reform bills. The U.S. House of Representatives approved a health care reform bill Nov. 7 (ADA News Today Nov. 10, Repeal of insurance antitrust exemption included in House health care reform proposal).

The ADA letter urges the Senate to:

  • increase dental Medicaid funding as an "investment now" for future savings;
  • extend dental coverage to Medicaid-eligible adults;
  • prohibit health plans from applying fee schedules to non-covered services;
  • improve the Medicaid database on payment levels and access barriers.

"The Association also wishes to express some concerns regarding other issues pertaining to health care reform bills before the Senate," said the letter signed by ADA President Ron Tankersley and Executive Director Kathleen O'Loughlin. The Association:

  • opposes any government-run insurance plan that would require provider participation, dictate fees for the private market, lead to a government-run health system or did not use market-billed rates in determining fee payments;
  • believes any reform legislation must include meaningful medical liability reform with limits on non-economic damages and attorneys' fees;
  • opposes health benefit taxes and provisions adversely affecting flexible spending arrangements and health savings accounts.

"The ADA is pleased that reform legislation places emphasis on prevention, which has always been a key component of oral health care in the United States," the policy letter said. "Specifically, we support provisions to provide more funding for public health infrastructure, including Centers for Disease Control and Prevention programs, Title VII (health personnel), and National Health Service Corps loan repayments.

"We also support provisions to encourage the use of electronic health records as long as there are rigorous privacy standards in place," the Association said.

The Association urged the Senate to retain in final legislation ADA-backed measures repealing the long-standing McCarran-Ferguson federal antitrust exemption for the health insurance industry, assuring competitive standing and consumer protections for stand-alone dental plans, and exempting small businesses with 25 or fewer employees from coverage mandates.

"Thank you for your consideration of the Association's suggestions, support and concerns," the ADA officials told Senate leaders. "ADA legislative staff will follow up with your office."

Association lobbyists were seeking Senate sponsors for dental Medicaid and non-covered services amendments not currently offered in either of two pending Senate bills, which Senate leaders are trying to merge toward passage of a final Senate bill and a conference with the House of Representatives, probably early in 2010.