While health insurance is regulated under multiple federal and state legislation to protect patients’ rights, there aren’t many legislations that regulate dental insurance. This has led to dental insurance companies being able to raise their rates without increasing patient benefits.
When I shadowed in a dental office that mainly serves the low-income population, the dentist almost always had to make treatment plans that were the cheapest for the patients instead of what was the best for their teeth in the long term. Aside from the bi-annual cleaning appointments, most dental insurance has minimal coverage for other procedures such as crowns, root canals, extractions, etc. Currently, without regulation, those insurance companies benefit from having limited coverage and denying claims.
This year, Massachusetts is looking to change this by introducing Question 2, or the “Medical Loss Ratios for Dental Insurance Plans Initiative” on the ballot this November. This initiative’s main objective is to establish the medical loss ratio for dental plans at 83% and require the insurer to refund the excess premium to its customers. Other changes the initiative proposes are that providers are required to disclose the projected medical loss ratio for plans, administrative expenses, and other specified financial information to the Division of Insurance by April 1, and providers are required to file group product base rates and changes to group rating factors by July. Additionally, the Commissioner of the Massachusetts Division of Insurance would be authorized to approve or disapprove of any product rates.
To simplify, voting “yes” for question 2 would mean agreeing to spend patient’s insurance payment on the patients themselves instead of on executives of dental insurance companies and other administrative costs. The Committee on Dental Insurance Quality, which is endorsed by dentist unions, the American Dental Association, and the Massachusetts Dental Society, is leading the “Vote Yes on 2” campaign in support of the initiative.
On the other hand, the opposing campaign is led by the Committee to Protect Access to Quality Dental Care, which is made up of dental plans, health plans, life insurers, and trade associations. They argue that “The proponents of this ballot question are not being straight with the voters” and that this “anti-consumer proposal will increase costs for Massachusetts families and employers — a nearly 40% premium increase in one recent study — and can result in thousands of residents being denied access to much-needed dental care” (Lisinski and Murphy).
This question on the ballot is crucial in fixing our broken dental insurance where dental insurance companies are allowed to gain excessive benefits from insurance plans that are meant to benefit the patients. In the past few years, states such as Maine, Kentucky, Missouri, Arizona, and Illinois had passed dental insurance reform laws to protect patients. If Question 2 is passed, Massachusetts will be the first state to require dental insurance companies to refund excess premiums to their subscribers if 83% of the premiums aren’t paid to patients’ care. It is hopeful that if the initiative is passed in Massachusetts, it will spread to more states and help more patients.
-Sherry Xu, Pre-Dental Student
Citations:
Garvin, Jennifer. “State Dental Societies Celebrate New Dental Insurance Reform Laws.”
American Dental Association, American Dental Association, 25 Aug. 2022, http://www.ada.org/publications/ada-news/2022/august/state-dental-societies-celebrate-new-dental-insurance-reform-laws.
Lisinski, Chris, and Matt Murphy. “Supporters of a Mass. Ballot Initiative Say a ‘Broken System’
Is Aiding Dental Insurers – at Consumers’ Expense.” The Berkshire Eagle, The Berkshire Eagle, 6 July 2022, http://www.berkshireeagle.com/statehouse/supporters-mass-ballot-initiative-say-broken-system-favors-dental-insurers-over-consumers/article_4072a302-fd70-11ec-acbf-5faab026fc9f.html.
“Massachusetts Question 2, Medical Loss Ratios for Dental Insurance Plans Initiative (2022).”
Ballotpedia, Ballotpedia, ballotpedia.org/Massachusetts_Question_2,_Medical_Loss_Ratios_for_Dental_Insurance_Plans_Initiative_(2022)#cite_note-opp-3.
ASDA: District 1 