April 4, 2014
The 2014 Regular Session of the Washington State Legislature ended just before midnight on March 13. The session concluded with the passage of a small bipartisan supplemental operating budget and little else. The two major fiscal issues, education and transportation, have been left for resolution for some time after November’s midterm elections. Only one bill tracked by WSDA was signed into law: HB 2351. This bill will allow out-of-state health practitioners to apply for temporary licensure to perform uncompensated care in Washington state; a mechanism already in place in most states. The following is a brief overview of the other issues that were active in the last half of the 2014 legislative session. A report on all of the legislative issues WSDA faced during the 2014 legislative session can be found online at www.wsda.org/blog.
Embedded Dental Benefits Inside of Washington’s Exchange:
HB 2467, legislation that would allow both embedded and stand-alone pediatric dental products to be sold inside of Washington’s exchange, died in the Senate. Starting in 2015, both stand-alone and embedded pediatric dental benefits can be offered in the insurance market outside of the exchange (currently all medical insurance outside of the exchange must have an embedded pediatric dental benefit). WSDA believes the same flexibility should be extended to purchasers using Washington Healthplanfinder.
EFDA Continuing Education:
SB 6138, legislation that would authorize the Dental Quality Assurance Commission to develop continuing education rules for EFDAs, died in the House. This bill is supported by the Department of Health, DQAC, and WSDA. SB 6138 was voted out of the Senate and the House Health Committee without opposition. However, the bill was not called for a vote before the entire House before the session ended.
Affordable Care Act (ACA) Update:
March 31 marked the end of the first open enrollment for medical plans offered on the state’s exchange (known as Washington Healthplanfinder). Preliminary numbers indicate that nearly 150,000 individuals enrolled in private medical plans through the exchange marketplace during the first six month open enrollment period. An additional 400,000 individuals who were made eligible for Medicaid through Medicaid-expansion also enrolled at Washington Healthplanfinder during its first six months of operation. National reports indicate that over 7 million individuals enrolled in private medical plans through the federally- run exchange, though this number does not include enrollments in state-run exchanges like Washington Healthplanfinder. WSDA will provide additional updates at www.wsda.org/blog.
In Washington, approximately 5,000 children were enrolled in stand-alone dental plans on Washington Healthplanfinder in the last six months. Only children in families with incomes above 300 percent of the federal poverty level (FPL) were able to enroll in stand-alone pediatric dental plans. The children of families whose incomes are below the 300 percent FPL threshold were enrolled in Medicaid. In Washington state, adults are unable to purchase dental insurance on the exchange. Plans to begin offering adult and family dental coverage on Washington Healthplanfinder are being considered, though the soonest these offerings would be available is 2016.
As health care implementation unfolds, the Association has been monitoring negative effects that impact the profession and patients. One area of concern is the coverage of preventive and diagnostic care on many pediatric dental plans. In many cases, patients are required to pay the entire out-of-pocket deductible before the carrier will pay for any pediatric dental procedures including diagnostic and preventive codes. Deductibles on many of these plans are thousands of dollars. WSDA is concerned that families may forgo routine, preventive care if this care must be entirely paid out-of-pocket.
Under the ACA, a list of preventive and diagnostic medical procedures must be covered by insurance carriers without copayment or deductible payment by the patient. Unfortunately, federal regulators did not include any procedures provided by the dental team on this list. The Association is examining potential legislative or regulatory action on this issue in 2015. Questions and concerns about this topic can be referred to Bracken Killpack, WSDA’s Vice President of Government Affairs, at firstname.lastname@example.org.