Rep. John Linder (R-Ga.) last week announced that he will retire after serving 18 years in Congress. Rep. Linder, one of only two dentists serving in Congress, has been a stalwart advocate for dentists and dental patients. The officers and staff at the ADA are disappointed to hear of Rep. Linder's announcement but wish him well.

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The White House is preparing a renewed push for health care reform legislation, which now appears will be based on the Senate bill and include House-offered adjustments already agreed to. The forthcoming legislation that would be important to dentistry:

• Consistent with the Senate bill, small businesses (fewer than 50 workers) would be exempt from any responsibility to contribute toward their employees' coverage.
• It would expand access to the National Practitioner Databank to quality control and peer review organizations, and to private insurance plans that furnish items or services reimbursed by federal health programs.
• Dental and vision benefits would no longer be counted as potentially taxable under the high-cost plan excise tax (tax on "Cadillac" health plans). This is a real win for the ADA, which has been very active in a coalition that lobbied this issue.
• More federal funding would be earmarked for populations added to the Medicaid and CHIP rolls as part of health care reform. This provision does not increase Medicaid reimbursement rates.
• The medical device fee would be dropped in favor of an excise tax to make it easier for the IRS to collect. This would help fund health care reform.

Staff, with input from officers and trustees, has put together a comparison chart of the House, Senate and Administrative proposals, available here .

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Rep. Diane Watson (D-Calif.) introduced H.R. 4615, the Consumers Have Options for Molar Protection Act (CHOMP), which would require dentists to provide patients with a fact sheet before placing any restorations. The ADA has responded with several initiatives, including a letter to congressional representatives asking them not to support the bill. The ADA letter pointed out the flawed premise behind the act and says the legislation introduces unfounded fears and undermines the doctor-patient relationship. The Association also asked Reps. John Linder (R-Ga.) and Mike Simpson (R-Idaho) to write and distribure a 'Dear Colleague' letter opposing the act.

In related news, the ADA succeeded in urging yet another member of congress to withdraw his support from Rep. Watson's anti-amalgam resolution, H.Res. 648. Rep. Harold Rogers (R-Ky.) last week took his name off the list of the resolution's cosponsors. To date, 11 lawmakers have withdrawn support.

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The House of Representatives today voted 406-19 to repeal the antitrust exemption provided to health insurance companies under the McCarran-Ferguson Act. Rep. Tom Perriello (D-Va.) introduced the bill (H.R. 4626) earlier this week.

The ADA has actively lobbied in support of this legislation because it would boost competition in the health care marketplace.

The legislation now moves to the Senate, and we will be ramping up grassroots activity to secure support there in the coming days.

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ADA President Dr. Ron Tankersley appears in today's USA Today story on the Pew Center on the States' report card on children's oral health. The Pew study , which ranked states in terms of access to oral health care among low-income children with a letter grade, reported that most states lack key policies to ensure access to cost-saving preventive treatments. Although six states received an "A" grade, the report noted that even children in those states have problems accessing care.

Dr. Tankersley is quoted in the article saying that inadequate Medicaid reimbursement rates are a key culprit in low access rates. "That is a huge issue," he said, adding that in states covering actual costs "dentists will step up to the plate and take care of these kids."

Many local and national media outlets are running stories on the Pew report card. An ADA statement went out on the major newswires.

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Democrats and Republicans are preparing for the White House's health care reform summit on Feb. 25. President Obama hopes to be able to retool reform legislation and get Republicans on board. For their part, Republicans are objecting to what they see as a political move by the president with very little chance to move real reform efforts.

Meanwhile, there is minimal movement in Congress: the reform bills that already passed both chambers are awaiting action to smooth out their differences, but election of Republican Scott Brown as the new senator from Massachusetts and the announced retirement of conservative Sen. Evan Bayh (D-Ind.) have effectively stymied Democratic efforts to get quick success. Now Democratic leaders seem intent on using the budget reconciliation process to get major portions of their legislation through (and avoid a filibuster). Aside from that, smaller, less contentious bills, like a repeal of the insurance industry’s antitrust exemption are likely to pass as stand-alone measures.

The ADA continues to lobby on issues important to dentistry like better federal support for Medicaid programs and an exemption for health care providers from the FTC's "Red Flags Rule."

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The ADA's Council on Govenrment Affairs (CGA) met Jan. 22–23 in Washington and laid out what it considers legislative and regulatory priorities for the coming year:

• Antitrust reform—The council calls for the repeal of the exemption from the McCarran-Ferguson antitrust act currently enjoyed by insurance companies.
• ERISA reform—CGA reaffirmed its support for proposed legislation it developed with the Council on Dental Benefits Programs that would assure all health plans must adhere to basic consumer protections, including a prohibition on applying a plan's fee schedule to services not covered by the plan.
• Oral Health Advocacy—The CGA recommended an oral health advocacy initiative that would be intended to better communicate that there are many barriers to accessing oral health care services, such as inadequate funding of public programs, oral health literacy, health status, geography, health behaviors, etc.
• Workforce—The Council will continue the ADA’s advocacy in response to any federal efforts with regard to dental workforce and support constituent societies' efforts to respond to state legislation concerning workforce.
• Tooth Whitening—The ADA will continue its efforts with regard to having FDA review tooth whiting products.
• Federal nutrition and food assistance programs—The Council recommends that the ADA continue to lobby for sound oral health policies in federal nutrition and food assistance programs.
• DEA Fees—The Council proposed that the Association initiate an effort to alleviate any potential future increases in fees imposed on dentists by the Drug Enforcement Agency.
• HIT—The ADA is to continue working to protect the interests of dentistry and dental patients with regard to legislation and regulations affecting health information technology and health care quality.
• Medical malpractice reform—The CGA is keeping reform of the nation’s malpractice reform laws a priority.

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