Richard C. Black, DDS, MS
Thomas Spangler, JD, MLIR
The ADA has had an active lobbying presence in Washington, DC, for a long time. When the ADA "lobbies" for a cause, the goal is to educate policymakers about how issues affect dentistry and dental patients and to persuade them to make decisions that positively impact dentistry. Although each state has its own dental society and establishes its own set of priorities, both state and local dental societies share information and work cooperatively with the ADA to ensure we are not sending mixed messages. This is accomplished with the help of our State Government Affairs staff members, who track a wide variety of state legislation and regulations.
These are just some of the issues the American Dental Association (ADA) lobbied for in 2014. Most of these issues will continue to be priorities in 2015 and beyond.
• Implementing and crafting amendments for the Patient Protection and Affordable Care Act (ACA)
• Relieving student loan debt
• Supporting pro-small-business tax reform
• Improving access to oral health care
• Seeking adequate funding for dental residencies, education, and research
• Spearheading efforts to reform the Employee Retirement Income Security Act (ERISA) and antitrust laws
• Working to establish Assignment of Benefits and Coordination of Benefits laws
• Supporting community water fluoridation
• Establishing good diet and nutrition standards for school children
• Supporting regulation of tobacco products
Although lobbying methods have changed over time, the underlying skill necessary for effective lobbying has not; lobbying still requires clear and frequent communication with all affected parties, including the members of the ADA. Effective communication involves a community-wide endeavor of staff and volunteer dentists working together throughout the country. The ADA Council on Government Affairs—composed of dentists from all 17 ADA districts, as well as liaisons representing new dentists, dental students, and other important constituencies—provides real-time member feedback on pending federal legislation and regulations. There are 10 other Association councils that also provide recommendations when the subject matter is within their area of expertise.
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The difference-maker in our advocacy is that our individual member dentists act in a collective fashion. The American Dental Political Action Committee (ADPAC), the second largest political action committee among specialty physician groups, oversees a grassroots network of 47,000 dentists who have relationships with their members of Congress. We regularly call on these dentists via "action alerts" to send emails to Congress. Over the last few years, we have used action alerts to try to persuade Congress to roll back some of the regulatory burdens placed on the profession by the Affordable Care Act (ACA), such as the medical device tax and the requirement that dentists register with Medicare in order to prescribe under Part D of the program. Supporting legislation to assist in easing the burden of student loan debt is also a high priority. Dentists attending the ADA Washington Leadership Conference (WLC) in May significantly increased the number of cosponsors for House and Senate bills that would, respectively, increase the deduction allowed for student loan interest and enable graduates to consolidate or refinance loans at a low fixed rate.
The partisan gridlock in Congress has made it difficult to move legislation to passage, but the federal regulatory agencies continue to roll unabated. So we are putting an increased emphasis on turning to members of Congress who, like us, believe that the agencies, in some cases, have overreached or have been unresponsive to our concerns. With the help of more than 500 dentists from 48 states attending the WLC, we helped Rep. Paul Gosar of Arizona finalize a letter with signatures from 74 members of Congress that asked the Centers for Medicare and Medicaid Services to take the necessary steps to ensure a fair and transparent Medicaid Recovery Audit Contractor (RAC) program, another ACA-mandated requirement.
Effective advocacy for dentists and patients involves more than lobbying. It requires reaching out to local communities to ask them to support initiatives that will help to make a real difference. One of those initiatives is the ADA's Action for Dental Health (ADH) program run by the Council on Access, Prevention, and Interprofessional Relations. ADH is a community-based, grassroots movement designed to provide care to people who suffer from untreated dental disease, strengthen and expand the public/private safety net, and bring disease prevention and education into communities. The good news is that our advocacy efforts on behalf of underserved populations appear to be working. Preliminary data presented at the Innovations in the Prevention and Treatment of Early Childhood Caries Conference on October 23 shows a downward trend in early childhood caries in the United States.
Ultimately, advocacy that adequately supports dentistry and improves the oral health of the American public requires the entire dental community to pull together. The ADA welcomes your involvement.
The ADA often lobbies for issues critical to dental practices, patients, and the profession. Some of the ADA's advocacy goals include:
• Extend the current $500,000 limit on Section 179 business expense deductions.
• Repeal the medical device tax.
• Ensure that dental offices will continue to be able to use the cash method of accounting and not be required to use the accrual method.
• Ameliorate the alarming levels of student debt that dental students face upon graduation by supporting better financing and interest deduction laws.
• Build Congressional support for eventual passage of the Action for Dental Health Act (H.R. 4395), which supports the ADA Access to Care initiatives under the Action for Dental Health program.
• Continue successful annual support of dental education and research funding.
• Continue to work with the Environmental Protection Agency to address remaining issues regarding pretreatment standards for amalgam waste.
• Provide tools and support to the state dental societies to help improve Medicaid, expand community water fluoridation, and pass noncovered services legislation.
Richard C. Black, DDS, MS, is Chair of the Council on Government Affairs. Contact him at [email protected].
Thomas J. Spangler, JD, MLIR, is Senior Director of Legislative & Regulatory Policy. Contact him at [email protected].