While the health reform debate chugged along on the Senate Floor this week, behind-the-scenes negotiations among key Senators over the "public option" resulted in a resolution that has Senate Leadership eyeing the finish line.  Like the House health reform bill, legislation introduced by Senate Majority Leader Reid, the Patient Protection and Affordable Care Act, includes a government-run insurance plan that would compete with private insurers in new marketplaces or "Exchanges" for the business of the uninsured.  The decision to include such a plan has been highly contentious among some lawmakers; but Senators emerged from a meeting on Wednesday night with news of a compromise that they say the Democratic Caucus will support. 
 
Details of the proposal were not made public; however, media reports indicate that it will include an expansion of the Medicare program and the creation two national, nonprofit, privately-run but publicly-administered heath insurance plans.  Specifically, individuals between 55 and 64 years old would be eligible to buy into the Medicare program, though it is unclear at this point how much they would have to pay.  The new national insurance plans would be run by the Office of Personnel Management, much like the Federal Employee Health Benefits Program (FEHBP), the insurance program for federal employees and Members of Congress.  This raises potential concerns because the benefits package offered under FEHBP includes incomplete coverage for oral health and is less than favorable for children.  Latest reports indicate that lawmakers are still negotiating the deal, so it is too soon to fully assess its impact.  CDHP will be monitoring this issue closely as negotiations continue.
 
Due to a backlog of legislative business the Senate will be forced to work through the weekend, forgoing a planned break in observance of Hanukkah.  Senator Reid says he will not relent, reiterating his intention to report out a bill by the year's end.  House Speaker Nancy Pelosi indicated that her Chamber is ready to weigh in on the Senate proposal when it is passed, even if that means working through the holidays or in the first few days of 2010.

Contact your Senators and Representatives today to schedule a meeting to talk about the importance of oral health.  Specifically, we recommend that you make the following key points:

• Preserve pediatric oral health care.  Both the House and Senate bills guarantee oral health care for children covered under the Health Benefits Exchange.  Given the importance of oral health to overall health, this is an essential element of the children's benefits package and must be included in any bill sent to the President.
  

• Defer to the House bill on oral health expertise.  The House bill requires that the Health Benefits Advisory Committee charged with overseeing the Health Benefits Exchange must include experts in oral health.  The Senate is silent on this issue.  Because oral health and overall health have not been traditionally integrated, experts in oral health will be necessary to help ensure appropriate decisions are made with respect to coverage, benefit design, system delivery and quality.

• Maintain oral health workforce provisions in the Senate bill.  The Senate bill includes significant provisions to expand training programs for dentists and fund demonstration grants for midlevel providers. Access to care is dependent on a sufficient investment in the oral health workforce and these Senate provisions must be maintained. 

• Maintain oral health prevention provisions in the Senate bill.  Senate provisions regarding oral health care prevention activities must be prevail, including a public education campaign; demonstration grants for dental caries management; school-based dental sealant programs in all 50 states; allowing school-based health centers to use funds for dental programs; and authorizing CDC grants to improve oral health.

To contact your elected officials, call the U.S. Capitol switchboard: (202) 224-3121 or go to the web sites of the U.S. House of Representatives and U.S. Senate.