Missouri lawmakers, specifically members of the Senate Freedom Caucus, are currently hindering legislation that would increase choice in oral health care providers through an expansion of workforce mobility and license portability. Senate Bill 778, which passed unanimously out of committee in January, would add Missouri to the Dentist and Dental Hygienist Compact (DDHC), allowing dentists and dental hygienists licensed in other DDHC member states to treat Missouri residents. Advocates of SB 778 believe that joining the DDHC would immediately increase the number of oral health care providers available to treat Missourians, reduce patient costs, and address the critical shortages of care providers in many parts of the state.
According to the Kaiser Family Foundation, as of November 2023, Missouri had 338 official dental care shortage areas, affecting more than 2 million people. By joining the DDHC, Missouri lawmakers could increase the supply of dentists and dental hygienists available to practice in these areas where care providers are desperately needed. It is puzzling to many that members of the Freedom Caucus are opposing a bill that expands the freedom to work in Missouri, especially when it could help alleviate critical shortages of care providers in various legislative districts. Proponents of SB 778 argue that greater workforce mobility and license portability align with the principles of the Freedom Caucus, yet its members are blocking this reform.
Contrary to concerns raised by some Missouri lawmakers, joining the DDHC would not relinquish any state authority to the federal government or an interstate commission. Under SB 778, Missouri lawmakers would still retain control over how dental care providers are regulated in the state. Missouri is already a party to various other interstate compacts, and proponents of SB 778 believe that extending this advantage to oral healthcare providers and residents in Missouri makes sense. Since January 2016, 170 pieces of licensure compact legislation have been passed by states, with 42 states and territories enacting occupational licensure compacts for various professions.
Those in favor of SB 778 argue that the failure to pass the DDHC would be a missed opportunity for the legislature and would result in millions of Missourians continuing to face insufficient access to oral health care. This opposition from a state freedom caucus is not unprecedented, as similar instances have occurred where legislation that would objectively expand worker or consumer freedom has been opposed. Ultimately, the decision to join the DDHC and expand workforce mobility and license portability for oral health care providers in Missouri remains in the hands of lawmakers as they consider the potential benefits and implications of this legislation.
