What changes might affect dentistry under President-elect Biden?

Broad, sweeping healthcare reforms are not expected under the administration of President-elect Joe Biden because it is unlikely that Democrats will control the U.S. Congress, panelists said during an Association of Dental Support Organizations (ADSO) roundtable discussion on December 1.

Instead, dentists are more likely to see small movements in areas such as surprise medical billing and teledentistry, said Dan Farmer, vice president of policy analysis and strategy within the health and life sciences practice at BGR Group.

"We don't expect Congress to come to an agreement in December, but this is an issue, and the plans and providers are getting closer to some type of agreement and there will be a fair amount of debate in 2021," Farmer said in reference to surprise billing.

Razor-thin margin

Though Democrats maintained control of the U.S. House of Representatives, the panelists believe it is unlikely they will hold the majority in the Senate. Control of the Senate hinges on two runoff elections in Georgia. Though Georgia helped hand Biden his win, many believe the Democratic Senate candidates are underdogs. Advance voting begins there in mid-December and the election will be held on January 5.

Regarding teledentistry, after the Centers for Medicare and Medicaid Services used emergency authorities to significantly broaden the availability of telehealth under Medicare during the pandemic, there has been bipartisan interest in Congress to extend it beyond the public health emergency, Farmer said.

Everyone should also pay attention to the fate of the Affordable Care Act (ACA). The U.S. Supreme Court recently held hearings on California v. Texas, a case that questions the law's standing, constitutionality of the individual mandate, and severability. A decision is not expected until the spring. The final decision will have a major effect on healthcare, Farmer said.

Clinicians should also anticipate the Biden administration overturning some of President Trump's administrative decisions, such as the use of short-term health insurance plans and non-ACA-compliant insurance plans. Biden will also likely roll back Trump's Medicaid work requirements, Farmer noted.

Republicans or Democrats?

One party alone isn't best for business or dentistry, added Bob Wood, BGR Group president and CEO.

"What is better for us from a business standpoint, as well broader dentistry, is divided government because we certainly didn't benefit from the ACA other than pediatric dentistry being included," he said.

The ACA, which will be a focus of the Biden administration, had a negative financial effect on plans and other areas, Wood said.

"Republicans are more business-friendly on the regulatory side but not as focused on public health and healthcare priorities. So, we have a divided government and ended up with the status quo," he said.