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Second Opinion: Legislation and the Dental Profession

Legislation and the Dental Profession:
Where You Stand and Why You Should Get Involved


Second opinions are common in health care; whether a doctor is sorting out a difficult case or a patient is not sure what to do next. In the context of our magazine, the first opinion will always belong to the reader. This feature will allow fellow dentists to share their opinions on various topics, providing you with a "Second Opinion." Perhaps some of these dentists’ observations will change your mind; while others will solidify your position. In the end, our goal is to create discussion and debate to enrich our profession.

— Thomas Giacobbi, DDS, FAGD
Dentaltown Editorial Director
 by U.S. Rep. Mike Simpson, DMD, (R-Idaho)

Out of the 435 Representatives and 100 Senators currently serving in the 110th Congress, 215 are lawyers. By contrast, there are only 13 doctors and two dentists. While lawyers and the law profession are well represented in Congress, the concerns of the medical and dental profession are not always as well understood by members of Congress, many of whose primary interaction with the medical profession has been limited to annual check-ups and teeth cleanings.

Dentists face unique challenges in today’s world. As small business owners, we understand the challenges of keeping health insurance affordable and accessible to your employees. As health care providers, we understand the challenges of dealing with the bureaucracies of private insurance and the State Children’s Health Insurance Program (SCHIP) and Medicaid programs and the challenges of providing care to these patients at a time when the reimbursement fails to cover even the costs.

The tragedy of Deamonte Driver, the young boy in Maryland who died after an infection from a tooth abscess spread to his brain in February 2007, demonstrates the tragic results that can occur when oral health needs are ignored. As dentists, we understand the need for people to receive proper dental care. This includes visiting the dentist for regular check-ups and seeking treatment when problems arise. We know that oral health means more than just healthy teeth – it is critical to a person’s overall health. Research continues to show that many diseases and conditions show themselves in the mouth. For people who don’t have access to dental care, oral disease is almost 100 percent inevitable – and almost 100 percent preventable.

This is particularly heartbreaking when it affects children. Children with poor oral health can have problems eating, sleeping properly, paying attention in school and even smiling because of pain. Unfortunately, many people don’t realize the extent and severity of untreated dental disease in children. In my home state of Idaho, more than 35 percent of children lack dental insurance. More than 25 percent of elementary school-aged children in Idaho suffer from untreated tooth decay, which can severely impact their health and well being. The pain and infection associated with untreated tooth decay can interfere with a child’s ability to learn, to eat nutritious and healthy foods, and to speak properly.

Tooth decay can also be costly. When a state stops providing optional dental benefits, it leaves eligible patients with few affordable options for oral health care. Instead of going to a dentist, many end up in hospital emergency rooms where the costs can be four times higher. Furthermore, oral health care provided through emergency rooms rarely resolves the underlying problem. Emergency rooms generally provide only pain relief and antibiotics for infection. Rarely do they provide dental care. Patients still must see a dentist to cure the condition.

Congress has considered a number of pieces of legislation this year that seek to address the issue of improving children’s access to oral health care, and many of these directly impact dentistry. Congress considered legislation to reauthorize the State Children’s Health Insurance Program, which I supported. For the first time, this legislation included a provision to provide dental care for children as a guaranteed benefit under SCHIP. While almost all states currently provide dental care as part of their SCHIP program, this guarantee would create stability within the program for dentists that choose to participate. While this bill was not signed into law during the current Congress, I am hopeful that we will approve a sensible reauthorization next Congress that will include dental care as a guaranteed benefit. As Congress considers any future SCHIP legislation, it is important that dentists and oral health providers weigh in with their support and educate their legislators about how important such a guarantee is to improving children’s access to oral health care.

I have also introduced legislation to address the challenges that dentists face in trying to improve oral health services for our nation’s children. While children enrolled in Medicaid have a federal guarantee for access to dental services through the Early Periodic Screening Diagnosis and Treatment program (EPSDT), accessing services is often difficult due to low reimbursement rates that contribute to an insufficient number of participating dentists. Overall, government health programs so poorly reimburse dentists that they are unable to recoup even their overhead costs. However, it has been demonstrated that improving reimbursement rates directly results in increased participation. For example, in Michigan, a recent pilot program found that an increase in reimbursement rates for Medicaid improved dentist participation rates by 58 percent.

HR 2472, the Essential Oral Health Act of 2007, would make targeted changes to improve access and delivery of oral health care services. More than 90 percent of all practicing dentists are in the private sector. This legislation would bring many more of these private practitioners into the dental Medicaid and SCHIP programs by increasing the federal medical assistance percentage (FMAP) for states that elect to increase dental fees to market rates and address administrative barriers. It would provide grants for the ADA-supported Community Dental Health Coordinator training programs and for volunteer dental programs that provide free dental care to underserved populations. In addition, it would encourage dentists to provide additional donated dental services by providing a $5,000 tax credit for free and discounted services provided to qualified low-income individuals. Dentists already provide $1.6 billion in charity care every year, and this legislation would provide them with a limited tax credit to help them recoup some of the costs associated with that care and hopefully encourage all to participate and do even more. This legislation will encourage more dentists to participate as Medicaid providers, and it will make it easier for them to provide care to underserved children.
Author's Bio

Michael K. "Mike" Simpson, DMD, is serving his fifth term in the House of Representatives for Idaho’s Second Congressional District. Simpson serves on the House Appropriations Committee. His subcommittee assignments directly reflect Idaho’s diverse economy and concerns; Energy and Water Development; and Labor, Health and Human Services and Education. In addition to serving on the Appropriations Committee, Congressman Simpson serves on the House Budget Committee. Simpson is one of the House’s leading advocates for a new energy policy and a renewed commitment to research and development of improved nuclear energy technologies. He has also gained national attention for his bill to split the massive, overburdened 9th Circuit Court of Appeals as well as his bill, the Central Idaho Economic Development and Recreation Act which addresses the concerns of economic growth and stability for rural Idaho and resolves long time wilderness debate over the Boulder-White Clouds. His political career began in 1980, when he was elected to the Blackfoot City Council. In 1984, he was elected to the Idaho Legislature where he served until 1998, the last six years serving as Speaker. Simpson was born in Burley, Idaho, and raised in Blackfoot. He graduated from Utah State University and Washington University School of Dental Medicine in St. Louis, Missouri. After graduation, he joined his father and uncle at the Simpson Family Dental Practice in Blackfoot.
These are just a few examples of the legislation currently before Congress that, if they had been signed into law, would directly impact dentists and oral health providers across the country. This January, the country welcomed a new President, a new Secretary of Health and Human Services, and new members serving in both the House of Representatives and the Senate and on the various committees that oversee our nation’s health, Medicare and Medicaid programs. Health care was a major topic during the recent presidential campaign, and it will continue to be a topic of great importance in the coming years. Americans across the country are concerned about the rising costs of medical bills and health insurance, and health care providers on the front lines have seen the strain that the uninsured and underinsured place on the system as people substitute regular check-ups with trips to the emergency room.

Already, Senators, Congressmen and the new administration are discussing the introduction of sweeping reforms to our nation’s health care system and developing task forces and working groups to look at potential reforms. While I believe that Americans receive the best health care in the world, we need to work to ensure that health care remains accessible to everyone. I don’t believe that a government-run national health care program, like those of Canada or Europe, is the answer to the challenges that the American system faces. Instead, I believe that we as a country need to decide what role the government will play in our health care, what role the employer will play, and most importantly, what will be the individual’s responsibility. At the same time, we must keep working to make health care available and affordable to all Americans. While improving access, we must also ensure that quality of care does not diminish. I believe that we must work together as a nation to find a bipartisan solution to reform our health care system. This solution must address the concerns of all stakeholders – including our dentists, doctors, nurses, hospitals, and patient and disease advocacy groups, to name just a few.

When I speak to dentists and health care providers across the country, I encourage them to consider getting involved in politics by running for their state legislatures or Congress. While most people recognize the impact of federal legislation, many of the critical issues facing dentists are actually addressed at the state level. For those dentists who are not interested in running for public office, staying engaged in politics is important. Now more than ever, as we consider health care reforms at the state and national level, it is critical that you, the dentists and oral health providers, participate in these discussions at the local and national levels and work to educate your lawmakers on how these decisions impact you as a dentist. After all, the individuals that know and understand dental issues the best are you –
the dentists.
Dentaltown Magazine
September 2025
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