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ADA seeks status quo on health care licensure in new North American treaty

December 13, 2018

By Jennifer Garvin

Washington — The ADA would like the new trade agreement between the U.S., Canada and Mexico to continue requiring health care providers from Canada and Mexico to meet all of the applicable U.S. licensing criteria “to ensure the safety of each patient.”

In a Dec. 11 letter to U.S. Trade Representative Robert E. Lighthizer, the Association noted that the North American Free Trade Agreement, which proceeded the United States-Mexico-Canada Agreement, did not allow Mexican or Canadian health care professionals to “circumvent state licensing and certification procedures.”

This was confirmed in a 1993 letter to the ADA from former trade representative Michael Kantor that stated “... NAFTA does not permit Mexican or Canadian professionals to practice a licensed profession in the United States, even on a temporary basis, without meeting all of the applicable state licensing criteria and receiving such a license. ...”

In the letter, ADA President Jeffrey M. Cole and Executive Director Kathleen T. O’Loughlin said, while the ADA “recognizes the long-standing tradition of providing opportunity to immigrants in the United States,” it does not believe it should compromise the standards of dental practice.

“To that end, the ADA believes that licensure by the states is a critical element in preserving those standards and is the mechanism to ensure only qualified individuals provide dental treatment and to ensure the safety of each patient,” Drs. Cole and O’Loughlin wrote. 

The ADA also pointed to Chapter 15 – Cross-Border Trade In Service of the United States-Mexico-Canada Agreement, which defines professional services as those which require “specialized post-secondary education, or equivalent training or experience, and for which the right to practice is granted or restricted by a party” and noted this definition “certainly includes the practice of dentistry within the United States” and corresponds to Chapter 12 of North American Free Trade Agreement.

In 1993, Mr. Kantor confirmed to the ADA that NAFTA “does not permit Mexican or Canadian professionals to practice a licensed profession in the United States, even on a temporary basis, without meeting all of the applicable state licensing criteria and receiving such a license.”

The ADA is requesting that language similar to the 1993 agreement be included in the renegotiated United States-Mexico-Canada Agreement treaty or “any bilateral treaty with Mexico, Canada or, for that matter, any other trade agreement whether bilateral or regional.”

“We further request that you confirm this position as it is of great importance to our membership and all practicing dentists in the 50 states, District of Columbia and Puerto Rico,” Drs. Cole and O’Loughlin concluded.