Across the country, volunteers from the AAO worked tirelessly in Fiscal Year 2021-22 to protect the interests of orthodontists and their patients, to ensure the quality of care and help practitioners build strong, sustainable businesses.
The AAO Council on Government Affairs and Legal and Advocacy team are involved in AAO advocacy efforts at the state, provincial and federal levels. Much of the AAO federal advocacy is made possible through the AAO Political Action Committee (AAOPAC).
Below you can find updates on AAO federal legislative achievements and priorities from FY 2021-22.
In June of 2021, Representatives Brian Babin (TX-36) and Chrissy Houlahan (PA-06) introduced the Resident Education Deferred Interest Act (REDI Act) to address the growing doctor shortage, help make medical education more affordable, and boost health care outcomes across the United States. The AAO joined over 30 other associations in the physician and dental communities in supporting this legislation, which is one of the AAO’s top education priorities.
In July of 2021, Representatives Gus Bilirakis (R-FL-12) and Tony Cárdenas (D-CA-29) reintroduced the bipartisan Oral Health Literacy and Awareness Act which directs the Health Resources and Services Administration (HRSA) to develop an oral health literacy strategy to reach underserved communities. The AAO joined the Academy of General Dentists and other dental coalition groups to offer support of this legislation and appreciation for considering this important initiative. The bill authorizes HRSA to develop a 5-year evidence-based oral health literacy campaign across the agency’s relevant programs.
On Wednesday, December 8, 2021, the Oral Health Literacy and Awareness Act (H.R. 4555) passed the U.S. House of Representatives with overwhelming bipartisan support. H.R.4555 was introduced in July 2021 by Representatives Tony Cárdenas (D-CA) and Gus Bilirakis (R-FL) to amend the Public Health Service Act and direct the Health Resources and Services Administration (HRSA) to increase oral health literacy and awareness in specific at-risk populations through a multi-year public health education campaign. The AAO also joined the Academy of General Dentistry and allies within the dental community, including many members of the Organized Dentistry Coalition (ODC), in sending a letter of support for this important legislation to the House Energy and Commerce Committee where it was subsequently approved and sent to the House floor to pass.
In December 2021, the AAO Legal & Advocacy team, in coordination with Cozen O’Connor Public Strategies, successfully led the effort that helped secure a bipartisan group of 21 Members of Congress to sign a letter sent to Comptroller General Gene Dodaro requesting the GAO “conduct a study of the federal regulation of Direct-To-Consumer (DTC) advertising practices for prescription medical products.” The signatories also indicated that a GAO review of these issues “will be an important step toward protecting consumers and towards mitigating any potential medical or public health harms that may arise from these marketing practices.”
According to the response from the GAO, the GAO will be investigating what the FDA and FTC are doing to regulate DTC products, including DTC orthodontic aligners. The AAO appreciates the GAO’s recognition of the importance of this issue in undertaking the upcoming investigation. The AAO likewise appreciates the members of Congress who signed the initial letter and their concern for the health and safety of patients who consider DTC products.
In December 2021, the U.S. Food and Drug Administration (FDA) published a discussion paper regarding 3D printing of medical devices at the point of care (locations such as hospitals and medical or dental offices). The purpose of this paper was to gather feedback to inform future policy development. The discussion paper was open for public comment for 60 days, providing background on FDA regulation of 3D printing devices and presenting a potential approach for future regulatory oversight. The AAO reviewed the FDA paper and filed a public comment, encouraging the FDA to avoid unnecessary regulations on 3D printing at the point of care.
During AAO’s Leadership Development Conference in Orlando in January, nearly 200 messages to Congress were sent from residents and orthodontists asking to support policies to ease the burden of student loan debt, specifically impacting graduating orthodontic residents by deferring student loans interest-free until residency is completed. The average graduating orthodontic resident today owes approximately $567,000 in student loan debt.
On March 15, 2022, AAO representatives including Dr. Stephen Robirds (AAO Trustee, Southwestern Society of Orthodontists), Andrew Wiltsch (AAO Associate General Counsel), and AAO’s federal lobbyists Cozen O’Connor Public Strategies, met with representatives of the Centers for Medicare & Medicaid Services (CMS) to discuss access to orthodontic care for individuals covered by government sponsored healthcare plans, including Medicaid coverage of Phase 1 orthodontic treatments.
The CMS representatives included Dr. Natalia Chalmers, the agency’s Chief Dental Officer. Dr. Chalmers, who assumed her role in August of 2021, is a board-certified pediatric dentist whose past work includes transforming health care data and information into actionable insights to address equity, improve care, and better inform policy and funding. The AAO Advocacy Team looks forward to continuing collaboration with CMS, as well as States’ Medicaid Departments, in order to address oral health equity and access to orthodontic care.
The Ensuring Lasting Smiles Act (ELSA)passed the U.S. House of Representatives on Monday, April 4 in a bipartisan vote of 310-110. The AAO was pleased to see that ELSA won support from both Republicans and Democrats.ELSA garnered the supermajority last September and had 304 co-sponsors plus Representative Eshoo as the main sponsor. ELSA closes a coverage gap to ensure that health plans cover medically necessary services related to a patient’s anomaly or birth defect, including any serious dental and oral-related procedures that are necessary to maintaining health and overall function.
On Tuesday, April 5 and Wednesday, April 6, 2022, the AAO held our annual Professional Advocacy Conference in Washington, D.C. This year, over 75 AAO members participated in the two-day event, which featured presentations from Cozen O’Connor Public Strategies (the AAO’s federal lobbying team), state advocacy partners, AAO staff, members of AAO leadership, a Biden Administration official, and two members of the U.S. House of Representatives. 16 members of Congress met directly with AAO members throughout the event in addition to meetings on Capitol Hill with legislative staffers from both the U.S. House of Representatives and the U.S. Senate.
The AAO members involved in this year’s Conference advocated on behalf of numerous AAO priorities including issues concerning direct-to-consumer or mail-order orthodontics, access to orthodontic care, small business issues and federal student loan relief.
A Note on the AAO Political Action Committee
Much of the AAO’s federal advocacy is made possible through the AAO Political Action Committee (AAOPAC). Established in 1994 to amplify the voice of the specialty of orthodontics and profession of dentistry in the federal government, AAOPAC allows the AAO to solicit funds from our members, and in turn contributes to candidates whose views are consistent with our goals.
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I am in full support of AAO members to protect patients from DTC products that are frequently provided with minimal orthodontic specialty diagnostic considerations and follow-up care.
Our specialty is strong due the decades of hard work by so many orthodontic academicians who have dedicated themselves to provide a strong educational background for our residents so that when they graduate they are able to provide optimal care for a variety of patient conditions.
Keep up the good work on all fronts and I will be presenting a paper at the upcoming CDABO meeting at the end of July that supports the efforts of AAO educators.