A Citizen Legislature
The Washington State Legislature is often referred to as a “citizen Legislature;” it is composed of people from different backgrounds and professional callings. Their backgrounds are as varied as their political views, ranging from law enforcement, firefighters and nurses to farmers, lawyers, business owners and social service providers.
Largely missing from the current list of legislator vocations: licensed dentists.
Right now, there’s just one licensed dentist in the entire Legislature: State Rep. Michelle Caldier, a five-term Republican legislator from the nearby 26th District which runs from Bremerton and Port Orchard in the north to Gig Harbor in the south.
Caldier has been a tireless advocate for the most vulnerable populations, including foster children, developmentally disabled children and adults and the elderly, during her time in Olympia. In 2013, she joined others to successfully lobby the Legislature to restore funding to adult dental care for those on Medicaid.
In 2018, WSDA honored Caldier with the association’s highest honor, the WSDA Citizen of the Year Award, for both her legislative work and her professional generosity. Caldier has donated more than $1 million in uncompensated care over the course of her dental career. She continues to be the elected official with the highest vote total in the 26th Legislative District.
“I first met Dr. Caldier when we worked together on the Seattle King County Dental Society Access Committee. She has always been a strong advocate for providing dental care to those that face the most barriers,” explained WSDA Executive Director Bracken Killpack. “Shadowing her for a day at one of the senior centers she worked at during the early 2010s deepened my appreciation for her commitment to serving the most vulnerable.”
Caldier’s professional interests have clearly translated into her decade long career in public service.
“As a sitting member of the House Health Care and Wellness Committee, she works every day as an advocate for patients’ rights, always ensuring that dental patients in Washington state are served with the highest quality care our profession can provide,” said WSDA President Dr. Nathan Russell. “Dr. Caldier is a true example of what a public servant embodies.”
This year, Caldier was again out in front for two key dental measures. House Bill 1655 would have required contracts between an insurance company and a provider to include a compensation increase for providers not affiliated with hospitals from the previous year based on the Consumer Price Index. In remarks prior to a vote on the bill in committee, Caldier championed an amendment that would have kept dental insurance in the legislation. Unfortunately, standalone dental plans were pulled from House Bill 1655 in the Health Care & Wellness Committee due to lobbying from Delta Dental of Washington. The bill died in House Appropriations a week later.
Before the vote to remove dental from the bill, Caldier said the following: “Since 2011, Delta Dental, Cigna and Premera – three top dental insurance companies in Washington – have reduced their rates to the tune of 15-25 percent across the board. [Dental plans] were initially included in all these discussions and there was a unity among providers...If [dental plans] ask for rate increases [from consumers], dentistry should be included with [reimbursement rate increases for providers…There should be unity across the board for providers and not a carve-out for dental.”
Another measure this session, House Bill 2176, perfectly highlights the benefits of having a dentist involved in the legislative process. Caldier served as the bill’s prime sponsor, a WSDA-supported effort to address the continuing shortage of dental hygienists in the workforce.
“As many of you know, we have a huge dental workforce shortage, and the biggest workforce shortage is in hygiene,” she said in committee testimony. “Many dental offices cannot find hygienists to fill those slots and so the dentist winds up doing the cleanings themselves,” she added. “This would allow the hygienist to work at the top of their scope of practice and would help improve the workforce shortages we currently have in our state.”
Another Voice for Dentistry
For Caldier, adding another dentist to the ranks of the Legislature would deepen the available knowledge pool on not only oral health issues, but other health care, workforce and insurance policy issues.
Washington state ethics laws prevented Caldier from commenting on campaigns during the legislative session as this article was being written. However, she was able to offer her thoughts on the value of dentists’ service in the Legislature.
“It is imperative that we get more dental and medical professionals elected to the Legislature. I am currently serving my 10th year in Olympia, and have been the only person who has ever had prescriptive authority the entire time I have been in office,” said Caldier in an email interview. “The lack of healthcare experience in the Legislature has allowed bills to pass that harm patient safety, increase workforce challenges, and erode the integrity of healthcare in our state,” she added.
“I am excited at the possibility of serving with another dentist.”
Gibbons previously worked with both Caldier and Rolfes on two key pieces of oral health legislation.
In 2017, he brought his experience to bear as the Public Policy Advocate for the Washington State Academy of Pediatric Dentistry to advance House Bill 1314. Caldier championed the measure, establishing a fair and predictable Medicaid audit process for pediatric dentistry. That same year, Gibbons and WSDA collaborated with Rolfes on Senate Bill 5976, expanding the Access to Baby and Child Dentistry (ABCD) program for the treatment of children with disabilities. Both measures were unanimously approved by the Legislature and are improving care for vulnerable patients.
Now, with his professional practice settled and his campaign launched, he’s ready to shift gears and think about what he could accomplish if given the opportunity to serve the people of the 23rd Legislative District and the state. Gibbons is running as a Democrat, but knows from his own experience as a policy advocate that collaboration and compromise are the best way to accomplish things in the Legislature.
“Although I come from a strong D district, I want to be sure all voices are heard,” he said. “That’s the way to make the best decisions. Now, that may put me at odds with some, but that’s OK – that’s where we need to be: bipartisan if at all possible,” Gibbons said.
“I’ve always tried to do something that would improve our profession, to better the care we can give to our patients,” said Gibbons. “As an advocate, I’ve been able to do that – explain to legislators what needs to be done. Now I have the opportunity to take what I know, and if elected, utilize that knowledge to be an expert in legislation on medical and oral health policy issues. I really respect Rep. Caldier’s advocacy on behalf of optimal patient care for all. I’m looking to join her in advocating for quality patient care from the other side of the aisle, which should be a bonus,” he added.
Wanted: Advocates for Oral Health
Montana State Rep. Jane Gillette knows all too well the demands of being a full-time dentist and an elected official. She also may have been one of the first of Gibbons’ colleagues to hear about his bid for the Legislature.
The Bozeman Republican and Gibbons have served together as ADA delegates; she is currently a member of ADPAC. She is also a PNW native, a graduate of the University of Washington School of Dentistry and an Air Force veteran. Her service brought her to Montana.
Gillette’s diverse career and unique background include work as a private practice dentist, but it was her work as a researcher on health disparities among children, the elderly and people with disabilities that honed her focus on public health. Gillette is one of the nation’s leading advocates for reducing health disparities and improving health outcomes via the production and utilization of high quality scientific evidence. She works closely with the ADA’s Center for Evidence-Based Dentistry and remains actively involved with the ADA House of Delegates and Montana organized dentistry.
As a legislator, she continues to draw on her professional expertise and interest in science to inform discussions with fellow lawmakers. In a legislative body dominated by farmers, ranchers, teachers and construction workers, she is just one of three people in the medical field – a nurse, an EMT and herself.
Gillette, who knows both Gibbons and Caldier, says having a background in public health, as all three do, is a significant advantage for a sitting legislator.
“I like to think I bring a science background and common sense to the table, whether it’s healthcare or the environment,” she said. “In Montana, the largest part of the budget is the Department of Health and Human Services – it consumes about two-thirds of the budget. Given how much tax money is spent [on those services], it speaks to the need to have people who understand not just clinical pieces but the health disparity piece – the social issues that families endure that make them either have poor health or different needs.”
Gillette was actively involved as an oral health advocate, reaching out to state legislators and members of Congress on a wide array of issues. Now, as a legislator and a member of the House Appropriations Committee in Montana, Gillette has the benefit of a broader perspective on the fiscal demands facing the state and how that intersects with policy decisions.
“I have a fuller view of it now. Before I was elected, I’d come in and ask to increase funding for children’s dental services. Now, I understand how many other competing issues we have – child welfare, foster care issues, really difficult things,” she said.
“For me, [becoming a legislator] hit home the need for the government to be responsible and good stewards of our tax dollars,” she added. “The role of the government is to take care of the basic needs of people. I think about that now, before I push that [voting] button.”
And while she concedes being an elected official is definitely a full-time job, she believes dentists are well positioned for the role of legislator.
“Dentists are helpers, they’re problem solvers – they want to help people,” said Gillette. “I just think dentists are natural leaders. Many of them also serve on school boards or are active with Rotary; some have been mayors of their towns. Dentists just have the temperament to make them natural leaders. They care deeply and have the perfect temperament for serving.
The 2024 Election
As of this writing, there are three candidates for Position 2 in the 23rd Legislative District, including Gibbons and the current appointee. Caldier is the only candidate who has filed for Position 2 in the 26th Legislative District. Candidates have until May 10 to file. The top two vote-getters for each race in the Aug. 6 primary proceed to the November general election.
Caldier and Gibbons will both be active campaigners for their upcoming elections.
“We’re doing this very thoughtfully and with people who understand how this works – even though it’s my first rodeo, it’s not theirs,” said Gibbons.
“I have volunteered for Rep. Caldier’s campaigns on several occasions and am very excited for the possibility of having two dentists serving in the 2025 Legislature,” said DentPAC Chair and WSDA Past President Dr. Cynthia Pauley. “While I know that Drs. Caldier and Gibbons will both work incredibly hard during these elections, having strong support for their professional peers is a huge boost for their campaigns. Your contributions and volunteering will make a difference.”
“We are fortunate to have such committed leaders and advocates in Dr. John Gibbons and Dr. Michelle Caldier who are willing to run for and serve in the Legislature,” said WSDA Executive Director Bracken Killpack.
“Organized dentistry would benefit greatly from having another dentist in Olympia.”
Rep. Caldier is a thought leader on health care issues in the Legislature. I know firsthand that many legislators respect her perspective. Too often, policymakers do not have either the medical background or the direct experience in the health care field to make informed decisions about policies that impact not just the practice of dentistry, but medical care more broadly,” he said. “Dr. Gibbons and Rep. Caldier bring a phenomenal breadth of knowledge and understanding of health care, insurance, workforce issues and small business.”
Gibbons knows he has lots of work to do, but is more than ready for the challenge ahead.
“I really need to get my name out there,” he said, noting that he is ready to go out, start knocking on doors, and leaving brochures with voters. “It’s pretty scary, but at the same time, pretty exciting,” he added.
“This is going to be a fun ride.”
A Quick Civics Refresher
By way of a quick civics review: There are 98 members of the state House of Representatives and 49 members of the Senate; they meet annually beginning on the second Monday in January. Legislative sessions alternate in length: In odd-numbered years, the Legislature convenes for a 105-day regular session to write the state’s two-year operating, capital and transportation budgets and pass other bills. They meet for 60 days in even-numbered years to make any needed adjustments to those budgets and consider other legislation.
As those elected to the state Legislature will confirm, there really is no such thing as being a “part-time legislator.” Lawmakers are compensated for their work – about $60,000 annually – which is set by the Washington Citizens’ Commission on Salaries for Elected Officials.
Practically speaking, being an elected official is a full-time job, on top of whatever other personal and professional commitments lawmakers may have.
Although the Washington State Legislature technically only meets part-time, there are plenty of obligations for lawmakers both during sessions and in the interim months between them. And while state senators are elected to serve four-year terms, state representatives serve for two years, meaning there’s always another election cycle close at hand.
Help WSDA Send Dentists to the Legislature
Having two dentists in the Legislature would help WSDA advance its advocacy efforts, including work on dental benefit reforms and addressing workforce shortages.
WSDA is encouraging members to contribute to both Rep. Caldier and Dr. Gibbons’ campaigns. The individual maximum is $2,400 ($1,200 for the primary election and $1,200 for the November general election).Learn more and donate at caldierforstaterepresentative.com and votedrjohngibbons.org.
This article originally appeared in Issue 1, 2024 of the WSDA News.