Inside a massive appropriations bill now in Congress is a provision which would allow federal funding for dental therapists.

Dental therapists perform basic dentistry, including fillings and simple extractions, under the supervision of a dentist. They can also work remotely, providing care in places like nursing homes or rural areas.

Dr. Frank Catalanotto, a founding member of Floridians for Dental Access, said when oral health is neglected, people often end up in a hospital emergency room.

"Tragically, Florida leads the nation," Catalanotto pointed out. "In 2019, we had 150,000 visits to a hospital emergency department because of a preventable dental problem. We had 4,300 admissions to the hospital because the infection was life-threatening."

He added in 2019, hospitals billed $630 million for dental-related care, with roughly half being Medicaid or not paid. He argued many such cases could have been avoided if people had access to affordable preventive dental care.

The Florida Legislature has seen multiple attempts to legalize dental therapy fail in committee over the last few years. Alaska was the first U.S. state to license dental therapists 15 years ago, with a dozen more since then.

Dr. Larry Hill, president of the National Coalition of Dentists for Health Equity, said Congress has made multiple attempts to fund dental therapy in recent years, only to see it removed from bills at the last minute. He is convinced dental therapists could help address the critical national shortage of providers.

"It could mean the difference, literally, in millions of people over time," Hill contended. "Not next week, not next year, but over time, it could make the difference in millions of people that can't now get care being able to access just routine care, preventive care."

The Kaiser Family Foundation estimates nearly 70 million Americans live in areas without enough dental care providers. Often, the locations are rural or in underserved minority communities.

In 2015, the Commission on Dental Accreditation adopted standards for training in dental therapy and there are currently four such programs in the U.S.

Catalanatto noted dental therapy is holding up under scientific scrutiny.

"One hundred percent of the published scientific evidence said that dental therapists are safe, provide high-quality care, are cost-effective and help improve access to care for underserved people in this country," Catalanotto emphasized.

It's been 13 years since more than 156,000 West Virginians gained health insurance coverage through the Affordable Care Act.

As sweeping and sometimes controversial as the ACA has been, its longer-term effects are still being felt today at the state level.

Gary Zuckett, executive director of the West Virginia Citizen Action Group, pointed to a new West Virginia law capping insulin copays at $35 per month. The law goes into effect January 1.

"I think we now have the best insulin copay cap legislation in the country that we just helped get passed in a very 'red' legislature," Zuckett noted. "Which does show you that health care is not partisan."

Federal data shows since the launch of the federal health insurance exchange, enrollment in health insurance plans has doubled from 8 million to more than 16 million nationwide.

According to the West Virginia Center on Budget and Policy, the Medicaid expansion included in the ACA allowed more than 200,000 West Virginians to gain access to health coverage.

Zuckett cautioned when the "continuous coverage" rules enacted during the pandemic expire April 1, the state will begin re-evaluating people's eligibility, which could signal a setback in progress.

"A lot of people won't qualify or won't fill out the paperwork, and they'll lose their health insurance in West Virginia," Zuckett explained. "That could be as many as 50 or 100,000 people. So, that's going to be a step backwards."

According to America's Health Rankings, around 6% of West Virginians were uninsured in 2021, far fewer than the nearly 16% of the state's population who lacked coverage prior to the Affordable Care Act.

Beginning next year, more Kentuckians will have expanded access to biomarker testing - which helps doctors customize cancer treatment. Advocates of the new law say it will save lives and improve patients' quality of life.

Signed into law by Gov. Andy Beshear, House Bill 180 requires both private insurers and Medicaid to cover biomarker testing after a cancer diagnosis.

Doug Hogan - director of government relations for the American Cancer Society Cancer Action Network (ACS CAN) - explained that without biomarker testing, doctors typically try several rounds of chemotherapy or other treatments, without knowing which will work best for the patient.

He said biomarkers increase the odds of matching the right treatment to a specific cancer.

"We will be the fifth state in the country to adopt an enhanced access to biomarker testing law," said Hogan. "And so, we're on the cutting edge. This is the way that we can utilize technology to improve health outcomes."

The bill passed unanimously in both the House and Senate. According to the American Cancer Society, more than 30,000 Kentuckians will be diagnosed with cancer this year.

Hogan added that the new law will allow care teams to use the latest technology to make the best decisions for their patients.

"It is so important for these patients to get that right treatment at the right time," said Hogan. "It really will improve their health outcomes. It will save lives in many instances, and certainly will improve the quality of life."

Research shows biomarkers can in many cases reduce the cost of therapy, especially for lung cancer and colorectal cancer patients.

Cancer-care costs are expected to top more than $245 billion by 2030, according to the American Association for Cancer Research.





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Oregon's nonprofit hospitals are not doing enough to provide assistance on medical bills for low-income patients, but a bill in Salem aims to change it.

Nonprofit hospitals are required by federal law to alleviate medical costs for patients who cannot afford them.

Matt Swanson, political strategist for the Service Employees International Union Oregon State Council, said investigations have found the institutions are not going far enough to help.

"People really aren't getting the assistance they need," Swanson explained. "Instead, they're getting every last dollar really wrung out of them in order to satisfy a bill that they really can't pay, and it's risking other things in their life, like housing and food and the ability to get over their health issue."

House Bill 3320 is designed to ensure people get the financial assistance they need and hospitals are transparent about their assistance practices. In written testimony on the bill, the Oregon Association of Hospitals and Health Systems said it agrees with parts of the legislation but wants lawmakers to keep in mind insurers are part of the cost picture as well.

Swanson added it is important for people who cannot afford medical bills to know they have assistance available.

"The purpose of this bill is to really tighten up what compliance looks like," Swanson emphasized. "And ensure that everyone gets screened before they are sent a bill, so that the hospital is giving a hand to folks who need the help, instead of letting them get lost in systems that are often confusing and overwhelming at a time when they're really struggling."

The bill received a public hearing last week and is scheduled for a work session Wednesday.


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