American Academy for Pediatric Dentistry Lobby Day C. Michael Gilliland, Partner Wednesday, March 24, 2010
CLIMATE ON THE HILL For well over a year, Congress has been involved in the health care reform debate. For the most part, it has been all health care all of the time. There have been hundreds of hours of congressional hearings and debate. On Saturday the House passed the health care reform bill by a veto of 219-212. The President signed it into law on Tuesday. Passage of health care is an historic achievement by Congress and the President, though a very partisan one, regardless of your position on the merits of bill. Congress is near the finish line on health care reform. The Senate will pass a reconciliation bill within a few days to make additional changes to the health care reform bill. That bill will then be sent to the President for his signature. 2
The Democrats that supported health care reform bill are elated and relieved that the bill has passed, but anxious for the coming elections. Republicans, who uniformly opposed health care reform, are angry that the bill passed, resolved to stay unified in their opposition to the bill and eager for this fall s elections. Everyone in both parties, Members and staff, are weary of this issue and ready to move on to other legislative matters after the Easter break. The health care reform bill did some good things for pediatric dentistry such as: Retains children s oral health coverage as part of any essential benefits package. Clarifies that separate dental insurance for children may continue to be offered under any insurance exchange. 3
However, a major problem in this bill for pediatric dentists is that it does not properly fund Medicaid dental services and therefore will not improve access to oral health care for those most in need. In meeting with Democratic offices that supported health care reform thank them for the good things that the bill does for pediatric dentists and health care generally. However, let the office also know that health care reform presents a major problem in that it does not properly fund Medicaid dental services. By extending Medicaid eligibility to millions of individuals without addressing the funding issue Congress is essentially denying these individuals real access to oral health care. Let the office know that you will revisit them at some point in an effort to address this very important issue. 4
What s Next in Congress When Congress returns from the Easter break it will have approximately 17 legislative weeks left before adjourning for the elections. Following the spring break, Congress will attempt to return to regular business. The Democrats will likely attempt to move financial reform legislation and another jobs bill. However, other significant legislation such as immigration reform and climate change will most likely be postponed until next year. Congress must turn to funding the government for fiscal year 2011. The President has submitted his budget for Fiscal Year 2011 and now Congress must pass 12 appropriations bills to fund federal departments and programs. In some years, Congress passes all 12 appropriations bills. In other years, Congress passes only a few of the appropriations bills and passes an omnibus bill to fund the rest of the government. This is very likely to happen this year. 5
Congress is currently holding hearings on the President s FY 2011 budget proposal. The House and Senate Appropriations Committees will begin to write the appropriations bills within the next few weeks. By summer, the House and Senate will be begin to take up and pass the various appropriations bills. Appropriations bill are suppose to pass Congress by September 30 th which is the end of the government s fiscal year. However, this almost never happens and we don t expect it to happen this year. Instead, Congress is likely not to pass most of the appropriations bills, or an omnibus bill, until the end of this calendar year or early in 2011. The appropriations bill which is of most interest to you is the Labor, Health and Human Services and Education Appropriations bill. This bill funds Title VII. The Chairman of this Subcommittee in the Senate is Senator Tom Harkin of Iowa and the Ranking Republican is Senator Thad Cochran of Mississippi. In the House, The Chairman of this Subcommittee is Representative Dave Obey of Wisconsin and the Ranking Member Republican is Todd Tiahrt of Kansas. The major decisions on writing this appropriations bill and funding Title VII are in the hands of these four Members of Congress. 6
For many years, the Academy has been successful in convincing the Appropriations Committees and Congress to provide direct funding in the Labor, HHS and Education Appropriations bills for pediatric dentistry training under Title VII. Last year, at the Academy s request, Congress set aside $7.575 million under Title VII for pediatric dentistry. Congress also added language in the appropriations bill stating that funding must also be used for faculty loan repayments. This appropriations set aside for pediatric dentistry has been extremely important in the growth and expansion of residency training for pediatric dentists. There is a clear shortage of pediatric dentist in the United States, we are simply not training enough pediatric dentist to meet the increasing need for pediatric oral health care services. The funding in the appropriations bill for pediatric dentistry is crucial to meet this need. 7
This year, the Academy is asking the House and Senate Appropriations Committees, and specifically the House and Senate Labor, HHS and Education Appropriations Subcommittees, to include $8 million for Pediatric Dentistry under Title VII. The $8 million we are requesting in Fiscal Year 2011 will go a long way in the process of filling the crucial need for more pediatric dentists. If a congressional Member you are meeting with is on the House or Senate Appropriations Committee ask them to urge the Labor, HHS and Education Appropriations Subcommittee Chairman and/or Ranking Republican to include $8 million for Title VII Pediatric Dentistry in their appropriations bill. If the congressional Member you are meeting is not a Member of the Appropriations Committee ask them to send a letter to the Subcommittee Chairs and/or Ranking Members with this same request. 8
The more Members that the Appropriations Committees and Subcommittees hear from on this issue the better chance we have with succeeding with our request. 9
Conclusion Above all, always thank the congressional office for taking the time to meet with you. If you are meeting with a staffer and not the Member treat the staffer exactly as you would the Member. The staff play a very important role in the legislative process. If you are meeting with a congressional office that has helped in the past on Title VII or other issues important to pediatric dentistry thank them for their help. Be passionate about the issue but don t come on to strong. Never assume that the staffer understands your issues. Be very basic in your briefing. Always have an ask of the congressional office. Most of all, as Heber always says, remind the office that it is about the kids. 10
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