Massachusetts Passes Dental Insurance Regulations



Massachusetts is the first state in the nation to mandate dental protections for consumers.

People fill out their ballots at Cathedral High School in Boston, Massachusetts on November 8, 2022. Joseph Prezioso/AFP via Getty Images

Massachusetts voters passed Question 2 of the ballot, making the state the first in the nation to introduce a uniform rule for a “medical loss report” for dental insurance.

The Associated Press called the race early Wednesday morning, with “Yes” at 71.3% of the vote.

The Yes on Massachusetts Question 2 campaign declared victory around 10:45 p.m. Tuesday night.

“Together, we put patients before profits. Meredith Bailey, DMD, president of the Massachusetts Dental Society, said in a statement.

The measure will create new dental insurance regulations, including a requirement that insurance companies spend at least 83% — 83 cents of every dollar — of premiums on patient expenses. The remaining 17 cents of each dollar can be used for administrative costs. Insurers who do not respect the percentage will have to grant discounts to patients.

Similar loss ratios are already used in health insurance. Nationally, insurers are required under the Affordable Care Act to spend at least 80% or 85% of premium dollars on medical care. In Massachusetts, medical insurers must spend 85 or 88 percent of dollar premiums on care.

The measures will also require dental insurers to send the state information annually on their “current and projected medical loss rate, administrative expenses, and other financial information.”

Proponents of the issue have argued that insured patients will pay less in dental costs and have more protections. Mouhab Rizkallah, a Somerville dentist who originated the ballot question, told that Question 2 “redirects the enormous waste and diversion of funds from patient premiums to patients.” The measure was supported by both the Massachusetts Dental Society and the American Dental Association.

The pushback on the issue mostly revolved around fears of rising dental costs and a potential loss of dental care for some residents. However, experts such as Evan Horowitz, executive director of the Center for State Policy Analysis at Tufts University, told that the measures won’t create big changes for patients.

“It’s not the kind of voting question that will transform dental care as we know it,” said Horowitz, who conducted an analysis of the voting question last month. “It’s not going to drive dental insurers out of the state, it’s not going to dramatically change the price of premiums, it’s not going to make care more affordable. This can make the price you pay at the dentist a bit higher, but maybe not even a noticeable amount. Not that much.”

The measures contained in question 2 will come into force in 2024. Until then, there is no minimum threshold for the part of the premiums that dental insurers must allocate to patient care.


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