CORRECTIONS: Michigan is one of 14 states, and therapists must pass comprehensive exams for licensure. (Feb. 24, 11:30 MST)

Experts agree that proper dental care is an important part of a person's overall health, but a chronic shortage of dentists makes some parts of Michigan "dental deserts."

Studies show that dentists are especially scarce in rural areas and marginalized urban neighborhoods, but many providers are turning to dental therapists to provide coverage where needed.

Dr. Michele Bloxson is dental director for The Wellness Plan Medical Centers, a group of Michigan-based healthcare clinics. She says dental therapists are licensed to perform primary preventive dental care and some basic restorative procedures.

"Just like when you have a medical provider in the medical field, you have a PA," she said, referring to Physician Assistants. "A dental therapist is an additional provider in the dental field, to provide services to those patients that are not able to receive care."

According to the Health Resources and Services Administration, nearly 61 million people in the United States live in dental-shortage areas. For individuals without access to a dentist, dental insurance, or money to pay for this type of care, Bloxson said dental therapists are a good alternative.

Michigan has had a pathway to license dental therapists since in 2021. According to the American Dental Therapy Association, it is one of about 14 states that has legislation supporting the profession.

The Michigan Dental Association has said a majority of rural dentists are nearing retirement age. There's an opportunity there, adds Misty Davis, RDH, Oral Health Program Manager at the Michigan Primary Care Association.

"Foundationally, the intent of dental therapy is to grow providers from the communities they will be serving. If Michigan education institutions align with this, we can strengthen our oral health workforce in the areas of diversity and cultural competence."

Bloxson said people in immigrant, Black or Latino communities are often more comfortable with a caregiver who looks like them.

"If you have a dental therapist to provide some of those adjunct services, it will benefit those areas as well," she said. "Patients that, when they go to clinics, they want to have someone that represents their ethnicity or someone that speaks their language."

Bloxson said training programs for dental therapists generally take two to three years to complete, and a growing number of U.S. colleges are adding it to their health-care curriculum. Graduates must pass a comprehensive licensing exam to receive a license to practice. Michigan colleges and universities are currently exploring program development. Until a program in operation in Michigan, aspiring dental therapists may pursue education in Alaska, Washington, or Minnesota and return to Michigan to practice.


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Access to reduced-price medication is a necessity for many rural Missourians with low income.

Rep. Cindy O'Laughlin, R-Shelbina, the Senate Floor Leader, said Big Pharma is trying to confuse legislators with unrelated hot-button topics such as abortion access and illegal immigration in a last-ditch effort to stop the state from joining a program to force drugmakers to sell medicines at a discount.

"Appealing to nuclear topics, which really do not apply in this situation, is a disingenuous way to try to defeat a bill that is actually good for Missouri," O'Laughlin asserted.

O'Laughlin pointed out the program is transparent, and uses the tax money saved to help low-income families deal with chronic conditions such as diabetes.

The drugmakers object to the government forcing them to give significant discounts, arguing hospitals' and for-profit pharmacies' bottom lines, particularly those owned by pharmacy benefits managers, are being exploited. Nationally, 46% of contract pharmacy agreements involve pharmacies linked to the three largest benefits managers.

Rep. Tara Peters, R-Rolla, introduced the 340B contract pharmacy access billand said the lobbying is absurd.

"Federally, 340B program does not allow for abortion drugs," Peters stressed. "Why would any legislation that we're trying to pass in the state allow for that? I mean, the thought of that even being in existence is absolutely ludicrous."

The Missouri Senate passed the bill 27-3 on Monday and it now goes to the House.


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Alabama is running out of time to tackle Medicaid expansion this legislative session.

More than 230 people gathered earlier this month with the group Alabama Arise, urging state lawmakers to prioritize the issue. Their message: Access to health care isn't just a matter of policy, it can be a matter of life and death.

Debbie Smith, Cover Alabama campaign director for Alabama Arise, said as the session winds down, the group will continue to echo the call for increased access to health coverage. She thinks it would not only save lives but revitalize communities across the state.

"Over 80% of our rural hospitals are operating in the red," Smith pointed out. "Not a great stat. About 19 rural hospitals are at immediate risk of closure, and those are the lifeblood of those communities. They're on life support."

Smith emphasized hospitals at financial risk also put their workforce at risk. Those who are against Medicaid expansion believe it is ultimately unaffordable for the state. However, Smith argued it could save the state nearly $400 million over the next six years. According to the Public Affairs Research Council of Alabama, those savings would be enough to cover the cost.

The council's study also showed Medicaid expansion would generate nearly $2 billion of economic growth. Beyond economic benefits, Smith pointed to the stark disparities in maternal and infant mortality rates in Alabama.

She stressed Medicaid expansion would do more than provide health care coverage during pregnancy or postpartum, it is about ensuring comprehensive coverage.

"We've been lucky enough to expand Medicaid coverage up to 12 months postpartum but we still need to figure out how to cover people before they even get pregnant," Smith asserted. "It's really important for people to have health coverage so they can address any kind of issues they might have, like if they have diabetes or high blood pressure that might affect their pregnancy in the future."

With limited time left in the legislative session, she noted one option could be Gov. Kay Ivey's executive authority to enact Medicaid expansion. Smith added using the power could be the simplest path forward, backed by the promise of additional funding from the American Rescue Plan.

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A Connecticut bill would expand the state's paid sick leave law.

The initial 2011 law requires 40 hours of paid sick leave for workers at employers with 50 businesses or more. The new bill covers all workers regardless of their employer's size.

Janée Woods Weber, executive director of the nonprofit She Leads Justice, said the legislation can benefit workers without access to paid sick leave.

"These are people for whom taking a few hours off when their child has a cold or perhaps they need to take themselves to a doctor's appointment are the kinds of challenges that many of us don't worry about, those of us who do have access to paid sick days," Woods Weber explained.

Small businesses were concerned about how the change could affect them. To address worries, the bill has a three-year implementation cycle giving them time to adapt. It also creates a task force studying the feasibility of providing tax credits to businesses with the smallest workforces. The bill passed the House and awaits a vote in the Senate.

An estimated 11% of workers are eligible for paid sick leave under the current criteria. Though expanding the law has taken over a decade, Woods Weber argued it has always been necessary.

"Nobody should be forced to make what is often times a very difficult and sometimes impossible choice between their livelihood," Woods Weber emphasized. "Getting a paycheck and getting to take paid time off to take care of themselves or a loved one if they get sick."

She added once the bill is passed, the state can build on it by allowing people to earn additional time off, at least up to 40 hours. It stems from the pandemic, when people had to isolate for up to five days if they contracted COVID-19, which could burn through their allotted sick time.


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