Massachusetts could be the first state to impose Obamacare-style regulation on dental insurance if voters approve a ballot measure to require that insurers put a certain percentage of the premiums they collect toward dental care.
The Medical Loss Ratios for Dental Insurance Plans Initiative would force insurers to spend at least 83% of premiums on dental services, versus administrative or other costs, or refund any excess to the beneficiary. Such a policy could be a model for other states or the federal government to follow.
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Health insurers are required to spend at least 80% of the money they take in from premiums on healthcare costs under the Affordable Care Act, but there is no minimum threshold in place for dental insurers.
Dentists and insurers have been fiercely divided over the initiative. Proponents of the measure, the American Dental Association and the Massachusetts Dental Society, claim that it would put patient’s interests over profits, preventing insurance companies from using the money for executive salaries or other overhead expenses unrelated to dental services.
The Massachusetts Academy of General Dentistry has also endorsed the measure, saying it would make dental providers “more transparent and accountable” to their patients. Dr. Mouhab Rizkallah, an orthodontist in the state, has been one of the largest backers of the initiative, directing $1 million toward it, according to a Boston Globe report.
Delta Dental, the largest dental insurance provider in the state, covering more than 2 million people, has been one of the largest opponents of the initiative, saying it could lead some insurers to raise premiums. The Boston-based insurance company argued that the initiative does not factor in all the costs that insurers face.
Former state Sen. James Welch with the Committee to Protect Public Access to Quality Dental Care told WGBH News that requirements for medical insurers should not be mandated for dental insurers because dental coverage is not required in Massachusetts and has smaller premiums to begin with. The Massachusetts Health Care Reform Law requires most adults in the state to have health insurance coverage or pay a penalty through their tax returns, unless they qualify for an exemption.
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If the initiative does not pass in November, then no changes will be required of dental insurers. If the measure does get approved by voters, it could spur other states to put forward similar proposals.
