Budget and Appropriations
At the beginning of each year, the President submits a proposed budget for the coming fiscal year. The House and Senate Budget Committees create an overall Congressional budget setting overall revenue and spending targets. Other standing committees report legislation authorizing programs in line with those overall targets. The Appropriations Committees then determine which programs to fund and at what levels based on the limits set in the Congressional budget.
The budget and appropriations process is often the battleground for other legislative policy riders.
For fiscal year 2022, ADEA has asked Congress to support $520 million for the National Institute for Dental and Craniofacial Research (NIDCR) and $46 million for Oral Health Training in General, Pediatric and Public Health Dentistry under Title VII Health Professions Programs, with a set aside of $14 million for General Dentistry Residencies, $14 million for Pediatric Dentistry Residencies, and $2 million for the Dental Faculty Loan Repayment program.
Dental and Craniofacial Research
Research is a major area of advocacy for ADEA. The discoveries made possible through the National Institute of Dental and Craniofacial Research (NIDCR) at the National Institutes of Health (NIH) improve health and saves lives. The Surgeon General’s report in 2020, “Oral Health in America: A Report of the Surgeon General” clearly positions oral health as part of total health and points to the emerging science that links oral infections and systemic conditions.
Discoveries stemming from NIDCR-supported dental research have reduced the burden of oral disease and have led to better oral health for tens of millions of Americans. Researchers have documented discoveries showing the important relationship between oral and systemic health. These findings will potentially contribute to the prevention or moderation of many serious systemic diseases. Poor oral health and underlying oral disease may significantly increase the risk of developing systemic conditions such as adverse pregnancy outcomes, cardiovascular disease, and diabetes. Research makes up a small fraction of the federal budget and generates an enormous return in technological advances and enhanced quality of life. “Boom and bust” cycles are inefficient strategies for funding cutting-edge research. Sustained, predictable growth in funding for research, as Congress has provided in recent years, maximizes the taxpayer’s investment and will lead to life-saving discoveries.
Federal Student Loans
Federal student loan policy is a high-priority issue for ADEA. The Public Service Loan Forgiveness (PSLF) Program was created and authorized under the College Cost Reduction and Access Act and signed into law by President George W. Bush in 2007. PSLF enables students with financial need to afford health professions and other graduate education and to pursue careers in public service, which helps address our nation’s shortage of health care providers in communities most in need. Thousands of health professions students rely on loan repayment and forgiveness programs such as PSLF as they serve their communities.
As part of the Budget Control Act (BCA) of 2011, Congress made graduate students ineligible for federal Direct Subsidized Loans (also called Stafford Loans). This means that interest would accumulate on those loans while a dental student is in school and on previous interest charged, this substantially increasing the debt load of new dentists.
ADEA is actively advocating for improved student loan financing terms and to allow dental school graduates to refinance their loans more than once to take advantage of market conditions that may lower the new dentist’s interest rates and monthly payments.
ADEA has also created a chart of state and federal loan forgiveness programs as of October, 2021. These programs are applicable to dentists, dental hygienists, and allied dental providers, where applicable, in all 50 states, the District of Columbia and Puerto Rico.
Higher Education Act (HEA)
From college access to student aid, from campus sexual assault to student data – The Higher Education Act of 1965 (HEA; P.L. 89-329) governs a wide range of federal higher education policy.
The HEA was last comprehensively reauthorized nine years ago under the Higher Education Opportunity Act of 2008 (HEOA; P.L. 110-315), which authorized most HEA programs through FY2014. The education law automatically extended the provisions for another year, and Congress provided funding for them in the FY2016 omnibus bill.
The House Education and the Workforce Committee and the Senate Health, Education, Labor, and Pensions Committee are said to be working on a new iteration of the HEA, and it is expected they will release their first draft before the new year.
Dental students graduate with relatively high debt compared to other graduate programs. Unlike other career paths, the debt burden is frequently compounded by years of post-graduate training, which is required for certain professionals to practice independently. As a result, student total loan repayment often exceeds two to three times the amount borrowed due to the accumulated interest/high interest rates, in addition to other unavoidable costs related to pursuing a dental education. The new authorization will provide ADEA the opportunity to update Members of Congress on the unique challenges and debt burdens faced by many dental students.