ADA highlights health policy issues in letter to RFK Jr.

Association highlights fluoride, Medicaid dental coverage

ADA leaders emphasized their support for community water fluoridation, expansion of Medicaid adult dental coverage and the independence of the National Institute of Dental and Craniofacial Research in a comprehensive letter to Robert F. Kennedy Jr., secretary of the U.S. Department of Health and Human Services. 

ADA President Brett Kessler, D.D.S., and Interim Executive Director Elizabeth Shapiro, D.D.S., J.D., highlighted several key health policy issues they believe should be prioritized during the Trump administration. The letter addresses agencies like Health and Human Services, the Centers for Medicare and Medicaid Services, and the National Institutes of Health.

The March 5 letter states that oral health is a critical component of overall health and that addressing challenges in this area will lead to improvements in the well-beings of Americans.  

Addressing the Department of Health and Human Services, the ADA said its priorities “reflect the ADA’s mission to improve access to care, integrate oral health into broader health care systems and promote evidence-based approaches to public health challenges.” 

The ADA stated in the letter that it partners with Health and Human Services on various critical public health initiatives, including efforts to integrate oral health into primary care and maternal and child health programs. The Association is focused on advancing oral health literacy through joint initiatives with the department, according to the letter, and urges the department to ensure that oral health programs are not included in agency reductions as part of the recent Office of Management and Budget memo on workforce optimization.  

Drs. Kessler and Shapiro also noted that while community water fluoridation continues to be a topic of public discussion, the ADA remains staunch in its support of the practice and welcomes discussions on additional research and stakeholder concerns. 

“The ADA looks forward to collaborating with the Department of Health and Human Services to address concerns, evaluate emerging research, and ensure that public health decisions related to fluoridation uphold the principles of evidence-based policymaking and transparency,” the dentists wrote.  

Addressing the Centers for Medicare and Medicaid Services, the ADA said in the letter that it strongly supports Medicaid adult dental coverage expansion. The Association also said it championed the position of a chief dental officer within CMS’ administrator’s office to ensure oral health issues remain a central focus in CMS policymaking and operations.  

The ADA has also been a consistent advocate for including adult dental coverage as an essential health benefit under the Affordable Care Act, according to the letter, as doing so would “better align oral health with broader health care delivery models.” 

“Through its ongoing collaboration with CMS, the ADA has actively contributed to policies that now provide coverage for dental services required prior to cancer therapies, organ transplants and cardiac procedures,” Drs. Kessler and Shapiro wrote.  

Addressing the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology, the ADA said it continues to advocate for policies that break down the barriers preventing health information exchange, ensuring that dental providers are fully integrated into broader health care systems.  

In the letter, Drs. Kessler and Shapiro encouraged the agency to update to the U.S. Core Data for Interoperability standards to U.S. Core Date for Interoperability standards to Version 5 by establishing an expiration date of Jan. 1, 2028, for Version 3. They also expressed support for assistant secretary for technology policy certification for dental vendors and for updating mandated transactions and operating rules under the Health Insurance Portability and Accountability Act, stating that the current mandated versions are outdated and fail to reflect changes in health care technology.  

“The updated versions of these standards will streamline administrative processes, decrease costs associated with health care payments, improve data quality, and better accommodate new health care services and delivery models. These updates will ensure efficient and accurate data exchange between health care providers and payers while maintaining patient privacy,” the dentists wrote.  

The ADA also emphasized the need for CDT codes to have parity with other standard procedure terminologies to ensure seamless integration of dental data into medical records. The letter further highlights concerns about the cost burden associated with these updates, calling for incentives to support dental providers and vendors in transitioning to new systems. 

Addressing the National Institutes of Health, the ADA expressed support for maintaining the specialized focus of the National Institute of Dental and Craniofacial Research as an independent entity rather than consolidating the agency’s 27 institutes and centers into 15 newly renamed centers. This proposed change “risks eroding the depth of expertise and innovation that comes from targeted research efforts,” according to the letter.  

Drs. Kessler and Shapiro said the ADA welcomes discussion about the adequacy and integrity of the federal research apparatus and that reforms must be evidence-based and informed by scientific expertise. They emphasized the need for continued and increased investment in the National Institute of Dental and Craniofacial Research, adding that dental, oral and craniofacial research is at the intersection of many critical public health issues, including chronic pain management, systemic disease prevention and health disparities.  

“The ADA remains committed to working with [National Institutes of Health] leadership, Congress, and the administration to ensure that any proposed changes enhance, rather than hinder, the ability of [the National Institutes of Health] and [the National Institute of Dental and Craniofacial Research] to fulfill their missions. The ADA firmly believes that maintaining [the National Institute of Dental and Craniofacial Research] distinct identity and focus is essential for advancing oral health research and innovation, ultimately improving the health and well-being of all Americans,” Drs. Kessler and Shapiro wrote.   

The letter goes on to address the Health Resources and Services Administration, the Indian Health Service, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, and the Food and Drug Administration. To read the full letter, visit this webpage.  

Notably, the letter raises concerns about Health and Human Services' decision to rescind the Richardson Waiver, which for over five decades ensured public participation in rulemaking processes. The ADA argues that eliminating this requirement reduces transparency in regulatory decisions and urges Health and Human Services to reinstate stakeholder engagement protections. 

“As you begin your tenure as Secretary of Health and Human Services, the ADA is eager to serve as a trusted partner and resource for your team. Oral health is a cornerstone of overall health, and we stand ready to collaborate on policies and initiatives that will improve access to care, enhance public health, and support the dental workforce across the country,” wrote Drs. Shapiro and Kessler.