Congress passes $1.4 trillion spending package
December 19, 2019
— Congress passed two legislative spending bills Dec. 19 totaling $1.4 trillion to keep the government running through the remainder of fiscal year 2020. The bills include funding for many of the Association's key advocacy issues affecting oral and overall health.
HR 1865, known as the domestic priorities and international assistance appropriations minibus, totals $540.4 billion and is made up of eight appropriations bills: Labor-Health and Human Services-Education, Agriculture, Energy and Water Development, Interior-Environment, Legislative Branch, Military Construction-Veterans Affairs, State-Foreign Operations, and Transportation-Housing and Urban Development. HR 1158, the national security appropriations minibus, totals $860.3 billion and includes the Defense, Commerce-Justice-Science, Financial Services and General Government, and Homeland Security appropriations bills. According to the White House, President Trump is expected to sign both measures into law.
Key advocacy wins for the ADA include:
• National Institute of Dental and Craniofacial Research.
Appropriators approved $477.4 million for 2020 — $15.6 million above the 2019 enacted level.
• Indian Health Services Division of Oral Health. The bill includes $210.6 million — an increase of more than $6 million. Funding includes $2 million for the electronic dental records system to enable IHS to bring more dental centers onto the system and to manage the current electronic dental record system. Congress also directed IHS to incorporate the electronic dental record in overall efforts to enhance its Electronics Health Record system. The IHS Health Professions account that includes recruitment and retention programs received $65.3 million, an increase of nearly $8 million over current funding. IHS estimated this funding would enable them to hire around 200 more health care providers.
• Centers for Disease Control and Prevention. The bill includes $19.5 million for the CDC Division of Oral Health.
• Health Resources and Services Administration. The bill includes $12 million each for general dentistry and pediatric dental residencies and $2 million for dental faculty loan repayment. Area Health Education Centers received $41.3 million — an increase of $2 million; $15 million for HRSA's Health Careers Opportunity Program; $13.1 million for HRSA’s Ryan White Part F Dental Programs; and $5.3 million for HRSA's Maternal and Child Health Special Projects of Regional and National Significance. There is also $300,000 earmarked for oral health literacy.
• Military dental research. The bill includes $10 million for military dental research.
The spending package also includes the following actions that impact oral health:
• The repeal of taxes created by the Affordable Care Act. This includes a permanent repeal of the 2.3% medical device tax that the ADA, AGD and other stakeholders have long advocated for. The bill also repealed the Cadillac tax and a fee on health insurance plans.
• Medicaid funding extension for U.S. territories for fiscal years 2020 and 2021. This includes program integrity improvements for Puerto Rico’s Medicaid program. This funding will be available at a federal match rate of 76% for Puerto Rico and 83% for the other territories. The ADA joined the Partnership for Medicaid coalition in urging Congress to fund Medicaid, including oral health, in the territories.
• Funding extension of Community Health Centers, National Health Service Corps and Teaching Health Center Graduate Medical Education through May 22, 2020. The ADA wrote to Congress in support of these programs that provide care to the underserved and train the dental workforce.
• Report language in the bill that encourages CDC and HRSA to engage federal partners and external stakeholders to strengthen support for Action for Dental Health initiatives, including the Community Dental Health Coordinator and ED Referral.
• Report language urging the Centers for Medicare & Medicaid to appoint a chief dental officer and to instruct auditors to utilize the clinical guidelines, best practices and policies of the ADA and American Academy of Pediatric Dentistry.
• Updates the Federal Food, Drug, and Cosmetic Act to increase the minimum age of sale of tobacco products from 18 to 21.
Follow all of the ADA’s advocacy efforts at ADA.org/Advocacy.