[Congressional Record Volume 165, Number 23 (Wednesday, February 6, 2019)]
[Senate]
[Page S921]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CARDIN (for himself and Mr. Wicker):
  S. 359. A bill to amend the Internal Revenue Code of 1986 to exclude 
from gross income certain Federally-subsidized loan repayments for 
dental school faculty; to the Committee on Finance.
  Mr. CARDIN. Mr. President, I rise today with my colleague Senator 
Wicker to bring your attention to our proposed Dental Loan Repayment 
Assistance Act. This legislation will provide incentives for dental and 
dental hygiene graduates to remain as dental school faculty by 
eliminating certain loan assistance benefits from being counted as 
taxable income. We rely on dental faculty to train the next generation 
of oral health providers, but too often, these educators find 
themselves pushed to work in private practice in order to pay off their 
student loans. The Dental Loan Repayment Assistance Act will ease some 
of this financial burden and allow faculty to stay where they are most 
needed.
  There are currently over 5,000 dental health professional shortage 
areas nationwide--areas where it is hard to find a dental provider even 
with insurance coverage. By 2025, the Department of Health and Human 
Services (HHS) projects that the United States will have a national 
shortage of 15,000 dentists. We can only hope to solve this problem if 
we can recruit and retain enough faculty to train the next generation 
of dentists and dental hygienists. Crippling educational debt should 
not prevent our Nation from having the oral health care providers it 
needs, and this bill will help address that.
  I would also like to take this opportunity to acknowledge that 
February is National Children's Dental Health Month. Since 1981, this 
month has afforded us the opportunity to acknowledge the importance of 
children's dental health. We recognize the significant strides we have 
made, but we also acknowledge the work that remains to be done. I 
invite my colleagues to join me to use this month to renew our 
commitment to ensuring that all children in our country have access to 
affordable and comprehensive dental services. To echo Former U.S. 
Surgeon General C. Everett Koop, ``there is no health without oral 
health.''
  Despite being largely preventable, tooth decay is the single most 
common chronic health condition among children and adolescents in the 
United States. It is four times more common than early-childhood 
obesity, five times more common than asthma, and 20 times more common 
than diabetes. Among children in families living below the federal 
poverty line, 52 percent have cavities. Children with cavities in their 
primary or ``baby'' teeth are three times more likely to develop 
cavities in their permanent, adult teeth, and the early loss of baby 
teeth can make it harder for permanent teeth to grow in properly. If 
tooth decay is left untreated, it not only can destroy a child's teeth; 
it can have a debilitating impact on his or her health and quality of 
life.
  Many have heard me speak before about the tragic loss of Deamonte 
Driver, a 12-year-old Prince George's County resident, in 2007. 
Deamonte's death was particularly heartbreaking because it was entirely 
preventable. What started out as a toothache turned into a severe brain 
infection that could have been prevented by an $80 extraction. After 
multiple surgeries and a lengthy hospital stay, sadly, Deamonte passed 
away--twelve years ago this month.
  Even in less tragic cases, tooth and gum pain can impede a child's 
healthy development, including the ability to learn, play, and eat 
nutritious foods. Recent studies have shown that children with poor 
oral health are nearly three times more likely to miss school due to 
dental pain, and children reporting recent toothaches are four times 
more likely to have a lower grade point average than their peers 
without dental pain.

  Tooth decay and oral health problems also disproportionately affect 
children from low-income families and minority communities. According 
to the National Institutes of Health, approximately 80 percent of 
childhood dental disease is concentrated in 25 percent of the 
population. These children and families often face inordinately high 
barriers to receiving essential oral health care and, simply put, the 
consequences can be devastating.
  In 2009, Congress reauthorized the Children's Health Insurance 
Program (CHIP) with an important addition: a guaranteed pediatric 
dental benefit. Today, CHIP provides affordable comprehensive health 
coverage--including dental coverage--to more than 8 million children. 
Thanks to CHIP, we now have the highest number of children with medical 
and dental coverage in history. In addition, in 2010, Congress included 
pediatric dental services in the set of essential health benefits 
established under the Affordable Care Act.
  I am very proud that my State of Maryland has been recognized as a 
national leader in pediatric dental health coverage. In a 2011 Pew 
Center report, ``The State of Children's Dental Health,'' Maryland 
earned an ``A'' and was the only State to meet seven of eight policy 
benchmarks for addressing children's dental health needs. In addition, 
in the Maryland Health Benefit Exchange, every qualified health plan 
now includes pediatric dental coverage, so families do not have to pay 
a separate premium for dental coverage for their children and do not 
have a separate deductible or out-of-pocket limit for pediatric dental 
services. I am pleased to say that our actions have been working, and 
our numbers are improving. In 2004, nearly 23 percent of all children 
had untreated tooth decay. In 2016, that number dropped down to 13 
percent.
  I urge my colleagues to join Senator Wicker and me in supporting the 
Dental Loan Repayment Assistance Act to help address our critical 
nationwide shortage of dental healthcare providers and especially 
dental faculty. We will not continue to allow crippling graduate 
student debt to deprive the American people of the teachers and mentors 
we need to train the next generation of oral healthcare providers.
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