Legislative updates from the American Student Dental Association

February 2013

From Washington

President Obama and Congress begin new terms

Last month, President Obama took the oath of office for his second term as 44th President of the United States. The President begins his second term amidst ongoing financial concerns; several elements of the fiscal cliff went partially unresolved or procedurally delayed (such as the budget sequestration). The President also needs to replace several Cabinet Secretaries, a political challenge as all Secretary nominations are subject to Senate approval.


On Tuesday, Feb. 12, the President will deliver the annual State of the Union address, in which he will report the condition of the nation as well as his legislative priorities for the 113th Congress. President Obama's anticipated legislative agenda consists of, among other things, comprehensive immigration reform, stricter gun control regulations, systematic climate change, the protection of social and entitlement programs as well as continued implementation of the Affordable Care Act (ACA) in 2014.


Unless otherwise addressed, the budget sequestration will activate automatic budget cuts effective March 1. A presumed half of the sequestration includes cuts to the national defense budget, whereas the other half would be applied to nondefense discretionary funding such as Medicare.


Over the coming weeks and months, ASDA will be working to identify the issues pertinent to dental students within Congress' activities. Issues such as student debt, STEM, health care reform, Medicare/Medicaid reimbursement and barriers to care can be addressed April 15-16 in Washington, D.C., at National Dental Student Lobby Day.


New legislation to overhaul Federal Direct Loan Program

Rep. Thomas Petri (R-WI) introduced the Earnings Contingent Education Loans Act, which would replace the Federal Direct Stafford Loan Program with an Income Dependent Education Assistance (IDEA) Loan Program.


Under the proposal, borrowers' monthly payments would be capped at 15 percent of their discretionary income, and the money would be withdrawn directly from their paychecks until their loan was paid off. The interest that accrues on a loan would be capped at 50 percent of its original balance. The proposal would also end most of the government's current loan-forgiveness programs and eliminate the subsidy that pays the interest on federal loans to undergraduates while they are still in school.


The National Association of Student Financial Aid Administrators (NASFAA) has been working with Rep. Petri's staff on this bill for several months. Rep. Petri introduced this legislation as what is called a "marker bill," meaning that it was introduced to float the concept and ideally gather support for its reintroduction next year. The bill will have to be introduced in the new 113th Congress and could be debated as part of the next reauthorization of the Higher Education Act. Source: ADEA December Washington Update.


IRS rules on medical device tax

In December, the Internal Revenue Service (IRS) issued its final regulation, implementing a 2.3 percent tax on all medical devices, including dental devices. Items such as supplies, materials, instruments and equipment are subject to the tax. A full listing of applicable devices can be found on the Food and Drug Administration site. This ruling came despite significant lobbying efforts from several groups within organized dentistry. ASDA will continue to monitor this issue and work with fellow dental groups in potential repeal efforts.


President Obama signs legislation to reduce regulatory burdens on clinical laboratories
On Dec. 4, 2012, President Obama signed into law the Taking Essential Steps for Testing (TEST) Act of 2012 (H.R. 6118). This legislation will give greater regulatory flexibility to clinical labs. The act is supported by the American Clinical Laboratory Association (ACLA), which asserts that the Centers for Medicare & Medicaid Services (CMS) faced difficulties because of inflexible rules on sanctioning labs that send test samples to other labs for analysis. Read more in ADEA December Washington Update.


"Pay As You Earn" loan repayment program available to eligible borrowers
In efforts to help borrowers better manage their loan portfolios, the U.S. Department of Education ("Department") has launched the "Pay As You Earn" (PAYE) Income-based Loan Repayment Program. Beginning on Dec. 21, 2012, eligible borrowers can apply for this enhanced income-based repayment program, which will allow them to pay an affordable monthly payment based on a percentage of their debt-to-income ratio. PAYE takes effect for new borrowers beginning July 1, 2014, and provides for both a lower income-based payment (10 percent of discretionary income rather than 15 percent) and a shorter time for full forgiveness (20 years rather than 25 years). Read more in ADEA December Washington Update.


Sen. Durbin reintroduces bills on private student loan education, bankruptcy

Sen. Richard Durbin (D-IL) recently reintroduced two bills related to private education loans: one designed to allow schools full certification of private student loans and the other to permit such loans to be discharged in bankruptcy proceedings like other types of private debt. These measures are as follows:

  • The Know Before You Owe Act (S.113): Amends both the Higher Education Act (HEA) and the Truth in Lending Act (TILA) to strengthen requirements surrounding private education loans, and to correct some technical flaws in the definition of private loans. Durbin first introduced the Know Before You Owe Act in March 2012 with Sen. Tom Harkin (IA) to address concerns that many students who take on private loan debt do not have full information about more advantageous federal aid programs.
  • The Fairness for Struggling Students Act (S.114): Allows private student loans to be discharged in instances of bankruptcy. In the 112th Congress, Durbin first introduced the Fairness for Struggling Students Act. The act would revise federal bankruptcy law to allow the discharge of private education loans if the loans demonstrate undue hardship to the borrower, similar to other forms of private debt.

Source: ADEA January Washington Update.


Registration open for Lobby Day, April 15-16 in Washington, D.C.

Registration for National Dental Student Lobby Day is now open. This is a great opportunity to get involved in advocacy and learn about what issues are important to ASDA and the profession. It also provides a rare opportunity to meet with your members of Congress and their staff and talk about what it means to be a dental student and what you'll be doing as a dentist. Talk to your chapter leaders if you'd like to attend.


From the States 

Midlevel provider legislation proposed in Washington State

In January, the Washington State Legislature introduced measures in the House of Representatives and the State Senate that would potentially expand the midlevel provider scope of practice. Companion bills (S.B. 5433 and H.B. 1516) attempt to increase access to dental care and disease prevention by introducing an evidence-based midlevel dental provider that is geared towards oral health disparities in the under-served areas. Furthermore, this legislation creates the professions of dental practitioner and dental hygiene practitioner. An additional bill, H.B. 1514, was proposed to regulate advanced function dental auxiliaries.


ASDA endorses expanded functions for dental auxiliaries only when each has received the appropriate education and training to guarantee competence, and when such functions fall within the laws established by their respective state of employment. ASDA policy also states only the dentist should perform the following functions: examination, diagnosis and treatment planning; prescribing work authorizations; performing irreversible dental procedures; and prescribing drugs and/or other medications.


ASDA will continue to monitor midlevel provider state legislation and work with state dental associations to ensure all practitioners maintain an appropriate scope of practice.


Andrew Smith, governance and advocacy manager
ASmith@ASDAnet.org | 312-440-2795
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