ADA asks Senate to pass legislation that would improve dental workforce, care access in rural communities

In a written statement submitted May 17 to the Senate Finance Health Care Subcommittee’s hearing, “Improving Health Care Access in Rural Communities: Obstacles and Opportunities,” the ADA thanked the subcommittee for prioritizing rural access to care issues and shared the Association’s priorities for addressing rural access to care and workforce issues.

“Addressing dental workforce shortages and maldistribution in rural areas so that everyone has optimal access to oral health care is one of the ADA’s top priorities,” the ADA said. “Dental access issues should always be included in discussions of general health care access issues, remembering both the unique aspects of dental practice and that oral health is health.”

The ADA shared its priorities for addressing rural access to care and workforce issues and highlighted four pieces of legislation that reflect the ADA’s support for solutions for student debt, public service, innovative programs and Medicaid expansion.

“Student loan debt presents a major impediment to attracting new dentists to underserved and rural communities,” the ADA said. “Ensuring that loan forgiveness programs are well funded, easy to navigate and expanded to include shorter time commitments or fewer mandatory weekly hours worked could go far in attracting new dentists to these communities.”

Legislation that would address student loan debt, the ADA said, includes:

• The Indian Health Service Health Professions Tax Fairness Act, which would allow dentists and other health care professionals participating in the IHS Loan Repayment Program to exclude interest and principal payments from their federal income taxes, as well as certain benefits received by those in the Indian Health Professions Scholarships Program. The bill would enhance IHS recruitment and retention efforts; help provide adequate access to care for IHS beneficiaries, especially in rural areas; save IHS nearly $12 million a year in taxes assessed on its loan recipients; and fund more than 250 additional loan repayment awards.

• The Restoring America’s Health Care Workforce and Readiness Act, which would double funding for the National Health Service Corps’ scholarships and loan repayment programs for dentists, dental hygienists and other health care professionals who serve in federally designated shortage areas. Expanding NHSC programs would address problems with health workforce distribution and local shortages, while also providing an opportunity for dentists and others to reduce student loan debt through service. The bill also would establish a NHSC Emergency Service demonstration project to improve the national health care surge capacity to respond to public health emergencies like the COVID-19 pandemic.

•  S. 704, the Resident Education Deferred Interest Act, which would allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program. The REDI Act would prevent physicians and dentists from being penalized during residency by preventing the government from charging interest on loans during a time when these resident health care professionals are unable to afford payments on the principal. Although the REDI Act does not provide any loan forgiveness or reduce a borrower’s original loan balance, it would allow medical and dental residents to save thousands of dollars in interest on their loans, making opening practices in rural and underserved areas or pursuing an academic or research career in those areas more attractive and affordable to residents.

The ADA also said that reauthorizing Action for Dental Health grants for innovative programs would fund programs designed to address the dental health needs of underserved, often rural, populations, including programs that focus on dental disease prevention through improved oral health education, reduction of geographic and language barriers and improved access to care, among other initiatives. The ADA also asked that Congress require the Secretary of Health & Human Services to submit a report to Congress on the extent to which the grants increased access to dental services in designated dental health professional shortage areas to ensure program accountability and transparency.

The ADA also said passing the Medicaid Dental Benefit Act, which would make comprehensive dental care a mandatory component of Medicaid coverage for adults in every state, would expand access significantly in rural areas, where nearly one in four non-elderly people are covered by Medicaid.

“Less than half of the states provide ‘extensive’ dental coverage for adults in their Medicaid programs. The others offer limited benefits, emergency-only coverage, or nothing at all for adults. Without a federal requirement, and given the competing priorities for state budgets, the optional adult dental benefit is often not provided by states. … As Medicaid oral health coverage opens the door to regular care in more appropriate and cost-effective settings, fewer people would turn to emergency departments to relieve dental pain.”

This legislation, the ADA added, could save the U.S. health care system $2.7 billion annually and eliminate barriers to dental care and empower people to pursue better jobs and careers.

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