I 
112TH CONGRESS 
2D SESSION 
H. R. 5909 
To improve access to oral health care for vulnerable and underserved 
populations. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 7, 2012 
Mr. CUMMINGS introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means, the Judiciary, Natural Resources, Veterans’ Affairs, 
and Armed Services, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To improve access to oral health care for vulnerable and 
underserved populations. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Comprehensive Dental 
Reform Act of 2012’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents of this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
Sec. 3. Findings. 
VerDate Mar 15 2010 
00:29 Jun 12, 2012
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6211
E:\BILLS\H5909.IH
H5909
jbell on DSK7SPTVN1PROD with BILLS
TITLE I—MEDICARE AND MEDICAID 
Subtitle A—Medicare 
Sec. 101. Coverage of dental services under the Medicare program. 
Subtitle B—Medicaid 
Sec. 111. Coverage of dental services under the Medicaid program. 
Subtitle C—Grant Programs 
Sec. 121. Case management grant program. 
TITLE II—PUBLIC HEALTH PROGRAMS 
Subtitle A—National Health Service Corps 
Sec. 201. National Health Service Corps. 
Subtitle B—Oral Health Education 
Sec. 211. Authorization of appropriations for oral health education for medical 
providers. 
Sec. 212. Oral health education for other non-health professionals. 
Sec. 213. Dental education. 
Sec. 214. Oral health professional student loans. 
Subtitle C—Other Oral Health Programs 
Sec. 221. Access points. 
Sec. 222. Dental clinics in schools. 
Sec. 223. Emergency room care coordination. 
Sec. 224. Research funding. 
Sec. 225. Mobile and portable dental services. 
TITLE III—DEPARTMENT OF VETERANS AFFAIRS AND 
DEPARTMENT OF DEFENSE MATTERS 
Subtitle A—Department of Veterans Affairs Matters 
Sec. 301. Requiring Secretary of Veterans Affairs to furnish dental care in 
same manner as any other medical service. 
Sec. 302. Demonstration program on training and employment of alternative 
dental health care providers for dental health care services for 
veterans in rural and other underserved communities. 
Subtitle B—Department of Defense Matters 
Sec. 311. Demonstration program on training and employment of alternative 
dental health care providers for dental health care services for 
members of the Armed Forces and dependents lacking ready 
access to such services. 
TITLE IV—FEDERAL BUREAU OF PRISONS 
Sec. 401. Demonstration program on training and employment of alternative 
dental health care providers for dental health care services for 
prisoners within the custody of the Bureau of Prisons. 
VerDate Mar 15 2010 
00:29 Jun 12, 2012
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6211
E:\BILLS\H5909.IH
H5909
jbell on DSK7SPTVN1PROD with BILLS
TITLE V—INDIAN HEALTH SERVICE 
Sec. 501. Demonstration program on training and employment of alternative 
dental health care providers for dental health care services 
under the Indian Health Service. 
TITLE VI—REPORTS TO CONGRESS 
Sec. 601. Evaluation of expansion of coverage for dental services. 
TITLE VII—FUNDING 
Sec. 701. Transaction tax. 
SEC. 3. FINDINGS. 
Congress makes the following findings: 
(1) The United States must establish a nation-
wide and comprehensive approach to address the 
lack of access to needed dental care and reduce oral 
health disparities. 
(2) Since 2000, when the Surgeon General of 
the United States called dental disease a ‘‘silent epi-
demic’’, there has been increasing but still insuffi-
cient attention given to addressing oral health 
issues. The Healthy People 2020 initiative includes 
oral health as a leading health indicator for the first 
time in the history of the Healthy People program, 
and in 2011, the Institute of Medicine published 2 
reports, ‘‘Improving Access to Oral Health Care for 
Vulnerable and Underserved Populations’’ and ‘‘Ad-
vancing Oral Health in America’’, that focused on 
oral health. 
(3) Dental caries, commonly known as cavities, 
are the most common chronic disease for children in 
VerDate Mar 15 2010 
00:29 Jun 12, 2012
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5909.IH
H5909
jbell on DSK7SPTVN1PROD with BILLS
the United States, affecting nearly 60 percent of 
children between 5 and 17 years of age. Addition-
ally, 25 percent of American adults who have at-
tained 65 years of age have lost all of their teeth. 
(4) Untreated oral health problems contribute 
to an increased risk for serious medical conditions 
such as diabetes, hospital-acquired pneumonia, and 
poor birth outcomes. 
(5) More than 47,000,000 individuals reside in 
areas where it is difficult to access dental care. Only 
45 percent of Americans over 2 years of age have 
had a dental visit in the preceding 12 months, and 
approximately 17,000,000 low-income children go 
each year without seeing a dentist. 
(6) While the lack of access to oral health serv-
ices is a national problem, those who are most likely 
to remain underserved are individuals with low in-
comes, racial and ethnic minorities, pregnant 
women, older adults, individuals with special needs, 
and individuals living in rural communities. 
(7) Nearly 9,500 additional dental providers are 
needed in order to meet this Nation’s current oral 
health needs, especially to work in areas where the 
need for dental care is the greatest. Only 20 percent 
of practicing dentists in the United States provide 
VerDate Mar 15 2010 
00:29 Jun 12, 2012
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5909.IH
H5909
jbell on DSK7SPTVN1PROD with BILLS
care to individuals enrolled in Medicaid, and a very 
small percentage of dentists devote a substantial 
part of their practice towards caring for individuals 
who are underserved. 
(8) Over 40 percent of the total expenditures on 
dental care in the United States are out-of-pocket 
payments by individuals. 
(9) The Medicare program and the Department 
of Veterans Affairs do not provide dental coverage to 
the majority of their beneficiaries, and States can 
elect whether to provide dental coverage to adults 
under the Medicaid program. 
(10) The number of individuals without dental 
health insurance is 3 times higher than the number 
of individuals who lack general health insurance. 
(11) The lack of access to oral health services 
can be extremely costly, resulting in higher health 
care expenditures. In 2009, there were over 830,000 
visits to emergency rooms across the United States 
for preventable dental conditions, which is 16 per-
cent higher than in 2006. 
(12) According to a report by the Surgeon Gen-
eral of the United States, students miss more than 
51,000,000 hours of school and employed adults lose 
VerDate Mar 15 2010 
00:29 Jun 12, 2012
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H5909.IH
H5909
jbell on DSK7SPTVN1PROD with BILLS
‘‘(3) EXCEPTION FOR SECURITIES LENDING AR-
RANGEMENTS.—No tax shall be imposed under sub-
section (a) on any covered transaction with respect 
to which gain or loss is not recognized by reason of 
section 1058. 
‘‘(g) BY WHOM PAID.— 
‘‘(1) IN GENERAL.—The tax imposed by this 
section shall be paid by— 
‘‘(A) in the case of a transaction which oc-
curs or is cleared on a facility located in the 
United States, such facility, and 
‘‘(B) in the case of a purchase not de-
scribed in subparagraph (A) which is executed 
by a broker (as defined in section 6045(c)(1)) 
which is a United States person, such broker. 
‘‘(2) SPECIAL
RULES
FOR
DIRECT, 
ETC., 
TRANSACTIONS.—In the case of any transaction to 
which paragraph (1) does not apply, the tax imposed 
by this section shall be paid by— 
‘‘(A) in the case of a transaction described 
in subsection (d)(1)— 
‘‘(i) the purchaser if the purchaser is 
a United States person, and 
‘‘(ii) the seller if the purchaser is not 
a United States person, and 
VerDate Mar 15 2010 
00:29 Jun 12, 2012
Jkt 019200
PO 00000
Frm 00046
Fmt 6652
Sfmt 6201
E:\BILLS\H5909.IH
H5909
jbell on DSK7SPTVN1PROD with BILLS