CDA Major Issues & Priorities 2021
1. AB 454/SB 242: Practice Stability and Plan Accountability - Co-sponsor
The COVID-1 9 pandemic has highlighted the ability of medical and dental plans to make record profits during a public health emergency by collecting premiums while paying Fewer claims when patients receive less care. Due to COVID-1 9, provider practices are suffering with reduced patient volume and significant increases in costs for personal protective equipment (PPE) and new infection control procedures. The majority of dental practices in California still have patient volumes at least 15% lower than pre-pandemic levels, while PPE costs have increased as much as tenfold. CDA and the California Medical Association are cosponsoring AB 454 by Assemblymember Freddie Rodriguez (D-Pomona), which would give the director of the Department of Managed Health Care and the Insurance Commissioner of California emergency authority to require plans to support providers through various means such as grants, increased rates, forgivable no-interest loans or payments for increased costs of mandatory infection control measures during any future public health emergency. State regulators need to have adequate options available during emergencies to ensure that provider networks stay intact and prevent major disruptions in access to care. While AB 454 focuses on future public health emergencies and natural disasters, CDA also strongly supports SB 242 (Newman), which is the urgent, near-term solution to reimburse providers for PPE and infection control supplies related to the COVID-1 9 pandemic.
2. AB 526: Vaccine Administration and COV1D- 19 Testing - Sponsor
CDA is sponsoring AB 526 by Assemblymember Jim Wood, DDS, (D-Healdsburg), which amends the Dental Practice Act to allow dentists to administer COVID-1 9 and flu vaccines. This bill would codify the current Department of Consumer Affairs waiver that allows dentists to administer COVID-1 9 vaccines during the ongoing COVID-1 9 public health emergency. Specifically, it would allow a dentist to prescribe and administer influenza and COVID-1 9 vaccines approved by the FDA in compliance with federal vaccination schedule guidelines.
Three states already allow dentists to administer vaccines and 21 other states have issued executive orders or similar types of authorization to permit dentists to administer COVID-1 9 vaccines.
AB 526 would also align the California Department of Public Health regulations with federal law so dentists can obtain the appropriate state licensure alongside their Clinical Laboratory Improvement Amendments certificate, which will allow them to conduct COVID-1 9 rapid tests to screen their patients and dental team members when such tests become widely available and appropriate for use in the dental office.
3. State Budget: Medi-Cal Dental Program Infection Control Reimbursement
CDA is requesting a one-time general fund appropriation of $40 million ($80 million total fund) to reimburse Med i-Cal Dental providers for some of the new COVID-1 9 related costs of mandatory, medically necessary infection control and PPE. Since dental practices reopened in June 2020, they have continued to have significantly increased overhead costs combined with decreased patient volume due to COVID-1 9 safety guidelines and lingering public hesitation around restarting health care treatment. State investments in the Medi-Cal program over recent years, including restoration of adult benefits, the Dental Transformation Initiative, Proposition 56 rate increases and administrative improvements, have led to a 20% increase in newly enrolled Medi-Cal dental providers since 2017 and significant increases in utilization of dental services. The state is at risk of backsliding on these gains due to the COVID-1 9 pandemic. Dental practices are having difficulty paying the additional overhead costs associated with the increased PPE necessary to provide care and are considering disenrolling from the Medi-Cal program, which will cause a constriction of the dental network and reduce access to care.
4. MICRA Repeal Ballot Measure - Oppose
The Medical Injury Compensation Reform Act allows injured patients to receive unlimited economic damages for all past and future medical costs, lost wages and lifetime earning potential. MICRA also allows up to $250,000 in noneconomic damages and includes a limit on attorneys' fees, stabilizes liability costs and reduces incentives for frivolous lawsuits against health care providers. A group of trial lawyers have qualified a ballot measure for the November 2022 election that would essentially eliminate MICRA's protections. This measure would undeniably raise health care costs and reduce access to care for those who need it most, including people who use Medi-Cal, county health programs, safety-net providers and school-based health centers.
CDA is part of Californians to Protect Patients and Contain Health Care Costs, a broad coalition including physicians, nurses, hospitals, safety-net clinics and other health care providers who are committed to fighting this initiative.
5. AB 733: Increasing Oral Health Care Through Medical-Dental Integration - Co-sponsor
CDA and the California Dental Hygienists Association are co-sponsoring a collaborative effort to help improve access to care for Medi-Cal Dental beneficiaries without a dental home. AB 733 by Assemblymember David Chiu (D-San Francisco) seeks to expand access to oral health care for Medi-Calenrolled children and pregnant people by allowing RDHAPs to partner with physicians in medical settings to provide fluoride treatments and oral health education and to coordinate care with dental providers and the dental care system. CDA and CDHA are working with stakeholders including the California Society of Pediatric Dentists, CMA, Children Now and the American Academy of Pediatrics-California on this collaborative effort to expand access to care and improve medical-dental integration.
6. AB 1400: Single Payer Health Care - Oppose
CDA is committed to improving the state's health care delivery system and to extending health coverage to all Californians. We are eager to work with lawmakers on solutions the state is capable of implementing to achieve universal coverage and protect the significant progress made under the Affordable Care Act (ACA), which allowed California to achieve a larger reduction in its uninsured rate than any other state. AB 1400 (Kalra, D-San Jose) would replace Medicare, Medi-Cal, all private insurance and the Covered California exchange with one state health care program. CDA has numerous concerns with such a proposal including the lack of any funding details and the great difficulty the state has meeting its existing obligations to underserved patients in the Medi-Cal program. Creating the single-payer health care system proposed in AB 1400 would also require passage of a ballot measure by voters, approval from the federal government and could require hundreds of billions in new tax revenues.
7. AB 1163: Sugar-Sweetened Beverage Local Tax Preemption - Co-sponsor Sugar-sweetened beverages are the single largest source of added sugar in the American diet. They are also the primary cause of various health conditions including tooth decay, which affects more than two-thirds of California children (making dental caries the most common chronic childhood disease). CDA and a coalition of more than a dozen leading health care organizations are pursuing legislation, AB 1163 by Assemblymember Adrin Nazarian (D-North Hollywood), to return power to local cities and counties, allowing them to pass local sugary drink excise taxes if they are appropriate for their own community. When the legislature passed a statewide preemption on these local taxes in 2018, the state eliminated a popular and helpful tool that municipalities can use to raise additional revenue and improve public health - dual policy objectives especially important in the wake of the COVID-1 9 pandemic.
Updated March 2021
ADA Response to "The Truth About Dentistry" article in The Atlantic
ADA communications staff is currently preparing a response to a story in The Atlantic titled, “The Truth About Dentistry.” The article alleges dentistry lags behind the medical profession and is not largely scientific and evidence-based in regard to diagnoses and treatment. The story also serves to reinforce negative stereotypes of dentists and focuses on one example of a dentist (now a retired life ADA member) who is currently being prosecuted for insurance fraud and has settled multiple lawsuits related to overtreatment and fraudulent billing activity.
ADA communications staff was not contacted by the reporter, who began working on this story two years ago. We learned of the story when he contacted an employee in the ADA Science Institute. The reporter interviewed this ADA employee, but he was not quoted – likely because his quotes did not support the apparent slant the reporter was pursuing.
ADA staff is currently working on a response to the article. A standby statement is in development and we will share when it’s finalized. If you receive a media inquiry and would like assistance, please don’t hesitate to contact me. These pages on MouthHealthy.org may also be helpful if you see any negative chatter on social media and would like to respond:
The ADA is engaging a number of communications tactics to share positive stories about the amazing work dentists are doing, including posting on Facebook and Twitter, which you can feel free to share from your own channels. We are also spreading the word to the public about how to be an informed consumer of dental care – look for a new infographic on social media in the next couple days. When sharing these positive stories, we would advise against mentioning The Atlantic story, as we do not want to give it more credence than it’s already received.
Thanks for your time. As always, please let me know if we can be of assistance. Thank you!
Mike Bittner email@example.com
Division of Integrated Marketing & Communications