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ADA asks Congress to prioritize CHIP, repeal medical device tax

January 18, 2018

By Jennifer Garvin

Washington — As Congress works to finalize a continuing resolution that will keep the government running until the end of 2018, the ADA is asking legislators to include two provisions important to dentistry: a six-year reauthorization of the Children’s Health Insurance Program and a two-year moratorium on the 2.3 percent excise tax imposed on the sale of medical devices.

In a letter to Senate and House leaders, ADA president Joseph P. Crowley and Executive Director Kathleen T. O’Loughlin urged lawmakers to prioritize both provisions, which play a “vital” role in maintaining affordable and accessible health care.

“CHIP provides much needed oral health services to nearly 9 million children and pregnant women,” Drs. Crowley and O’Loughlin wrote. “Dental care has the highest level of cost barriers compared to other health care services, with more individuals forgoing needed dental care over prescription drugs, medical care, eyeglasses or mental health services.” 

They reminded lawmakers that poor oral health can have serious long-term effects on an individual’s life and pointed out that CHIP offers affordable coverage that is “specifically designed” to meet the needs of children, including pediatric oral health services. 

“More importantly, CHIP helps working families afford health coverage by capping premiums and cost-sharing to 5 percent of a family’s income,” Drs. Crowley and O’Loughlin wrote. “As health coverage costs continue to rise, CHIP provides a safety net for families in every state. Nearly 90 percent of children in CHIP live in families with incomes less than 200 percent of the Federal Poverty Level, or $40,480 for a family of three. Ensuring access to comprehensive coverage and providing continuity of coverage for our nation’s low-income children should be a priority.”

The ADA also strongly supports the repeal of the medical device excise tax, which was imposed in 2013 under the Affordable Care Act, frozen in 2015 and reinstated on Jan. 1, 2018. The tax includes restorative materials, instruments, impression materials and equipment.

“The dental manufacturing industry estimates that the medical device excise tax will increase the cost of dental care by over $160 million annually resulting in harm to our patients and an increase in the overall cost of health care,” Drs. Crowley and O’Loughlin wrote, adding that an increase in oral health care costs as a result of the excise tax on medical devices could make health care less affordable and act as a deterrent to patients seeking dental care.

“As you know, health care professionals who operate solo or small group practices are economic engines for their communities. In 2010, the most recent year for which we have survey data, 96.2 percent of the dentists surveyed reported that they work in practices comprising five or fewer dentists. The nature of dental insurance plans means that a dentist’s reimbursements may not keep pace with this tax and many offices will have to absorb most of the increased cost. Operating costs for dental practices, particularly specialties, are significant, and the ability to sustain or grow small businesses like dental practices will be further constrained under this new excise tax.”

The letter concluded with Drs. Crowley and O’Loughlin noting that the ADA remains concerned about the future of community health centers and the National Health Service Corps.

“Both programs are in need of full reauthorization as they are critical to increasing access to quality health care in rural and underserved communities. We look forward to working with Congress on improving access to oral health care for all Americans, including our most vulnerable.”

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