Missouri lawmakers, particularly members of the Senate Freedom Caucus, are currently halting the progression of a bill, Senate Bill 778, that aims to increase choice in oral health care providers through the expansion of workforce mobility and license portability. The bill, which passed unanimously out of committee in January, would add Missouri to the Dentist and Dental Hygienist Compact (DDHC), a new interstate compact that would allow dentists and dental hygienists licensed in other member states to treat Missouri residents. Proponents of SB 778 believe that joining the DDHC would increase the number of oral health care providers available to treat Missourians, ultimately reducing patient costs and addressing critical shortages of care providers in many parts of the state.

As of November 2023, Missouri had 338 official dental care shortage areas, affecting over 2,000,000 people. By joining the DDHC, proponents argue that Missouri lawmakers can increase the supply of dentists and dental hygienists available to practice in these underserved areas, helping to alleviate the shortage of oral health care providers. Despite the potential benefits of joining the DDHC, members of the Freedom Caucus are holding up the bill, sparking confusion among many who believe that expanding worker freedom to address critical shortages aligns with the Caucus’s founding principles.

Contrary to concerns raised by some Missouri lawmakers, joining the DDHC would not cede state authority to the federal government or an interstate commission. Under SB 778, Missouri lawmakers would retain control over how dental care providers are regulated in the state. In addition to the DDHC, fifteen other licensed professions have interstate compacts that have been successful in Missouri and across the country. Proponents of SB 778 argue that it only makes sense to afford this advantage to Missouri’s oral healthcare providers and residents.

Proponents of SB 778 highlight the success of licensure compacts in other states, with 42 states and territories enacting occupational licensure compacts in various professions since January 2016. Failure to pass the DDHC, they argue, would result in millions of Missourians continuing to face limited access to oral health care services. While SB 778 presents a significant legislative opportunity to expand worker and consumer freedom, it wouldn’t be the first time that a state freedom caucus has opposed legislation that objectively promotes freedom.

Overall, the delay in passing Senate Bill 778 in Missouri highlights the ongoing debate surrounding the expansion of workforce mobility and license portability in the oral health care industry. As critical shortages of care providers persist in many parts of the state, joining the DDHC could provide much-needed relief to Missourians in need of oral health care services. It remains to be seen whether Missouri lawmakers, particularly those in the Freedom Caucus, will ultimately support this legislation and ensure greater access to oral health care for all residents of the state.

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