Lobby Day 2018: The issues you need to know

Next week, hundreds of dental students and dentists will be participating in my favorite day: lobby day. This year will be exciting, as we have two pieces of legislation that have passed the House with overwhelming support, and it’s also the second year that ADA and ASDA have lobbied together on Capitol Hill. The beauty of this day is that regardless of race, gender, religion, sexual orientation or political persuasion, we unite as one “tooth party” to advocate for legislation that promotes oral health.

For some, this day is a #30 buccal pit, but for others, it feels like hand filing dilacerated, calcified canals on #15. Yet this will be one of the greatest days of your life if you just remember these two things:

1. Politicians are just like you and me. They are mothers, fathers, sons and daughters. They are a product of their upbringing, and while they may have different opinions, they all seek to better the lives of their citizens. More importantly, they want to hear from you.
2. Preparedness is next to godliness.

Being prepared for this event means knowing the issues. Each year, ASDA and the ADA determine which issues in Congress align with our legislative priorities. The first day of programming at lobby day is geared toward educating you on the issues, allowing time for Q&A and strategizing with your state. Here’s an overview of the issues.

Issue 1: McCarran-Ferguson

Formally known as the Competitive Health Insurance Reform Act of 2017, H.R. 372, this bill was introduced by fellow dentist and Arizona congressman Rep. Paul Gosar. The bill passed the House in 2017 with a 416-7 vote. The intent of this legislation is to reinstate federal antitrust laws as it applies to health insurance companies. Currently, insurance companies and major league baseball are the only two industries exempt from federal antitrust laws, allowing them to share data with each other about premium rates, reimbursement and more. Meanwhile, it is illegal for dentists in the same market to discuss their own pricing with each other, as it constitutes collusion. While insurance companies claim it is necessary, it reduces market competition and allows legal collusion, resulting in less options and protection to consumers.

How to approach this in meetings with representatives?

You will have a list of the representatives who voted in favor of the bill. Be sure to thank them at the end of your meeting.

How to approach this in meetings with senators?

We expect a Senate counterpart to this bill to be introduced shortly.

Issue 2: Dentist and Optometric Care Access Act of 2017 (“DOC Access Act”) H.R. 1606

Introduced by Rep. Earl “Buddy” Carter of Georgia, the bill aims to prevent dental and vision insurance carriers from dictating what doctors may charge for non-covered services. For example, even though the dental plan may not offer coverage for veneers, because the dentist has contracted with a benefit plan, the carriers can dictate what the dentist may charge for veneers. Historically, this has been used as a marketing tactic to suppress smaller carriers who did not have the market share to offer similar discounts. This can appear beneficial to consumers; however, as carriers consolidate, the result is less competition and monopolistic tendencies. Consumers, ultimately, lose out with less competition, less choice and less innovation in the marketplace. Furthermore, dentists continue to lose autonomy.

How do I approach this in meetings with representatives?

Ask them to co-sponsor this bill.

How do I approach this in meetings with senators?

You will only discuss this in meetings with representatives, as there is no Senate companion bill.

Issue 3: Opioid Epidemic

In 2016, opioids were responsible for over 40,000 deaths in the United States. Further, more than 1.8 million Americans suffer from opioid dependence or abuse. The president has declared opioid addiction a public health emergency and is seeking solutions to the epidemic. Dentistry, amongst other health professions, has worked over the past decade to curtail opioid abuse by turning to evidence-based prescribing protocols, educating dentists on acute dental pain management and substance abuse, and partnering with different stakeholders to raise awareness.  ASDA recently adopted a policy to encourage dental schools to provide resources to students to address opioids with their patients. On March 26, the ADA released a new opioid policy that emphasizes the following as legislative priorities:

• Require CE for opioid prescribers
• Impose statutory limits of seven days on opioid prescriptions for initial treatment of pain
• Support the use, improvement and collaborative efforts of state prescription drug monitoring programs

How do I approach this in meetings with representatives?

Inform them of the issue and the policies ASDA and ADA view as potential solutions.

How do I approach this in meetings with senators?

Same as above.

Student are also expected to be well-versed on the student debt issue and to contribute to the Action for Dental Health Act discussion. The aforementioned bills are practitioner-focused, so don’t fret if you do not feel comfortable with them; this is just an introduction. You will be able to ask plenty of questions during the training sessions and discuss with dentists in your state.

If you have any questions, concerns or would like additional information, you can email advocacy@asdanet.org.

~Jon Vogel, Texas-Houston ’18