Massachusetts vscould be the first state to impose Obamacare-style regulations on dental insurance if voters approve a ballot measure requiring insurers to spend a certain percentage of the premiums they collect on dental care.
The medical loss ratios initiative for dental insurance plans would require insurers to spend at least 83% of premiums on dental services, relative to 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 receive from premiums on healthcare costs under the Affordable Care Act, but there is no minimum threshold in place for dental insurers.
Dentists and insurers were fiercely divided over the initiative. Proponents of the measure, the American Dental Association and the Massachusetts Dental Society, say it would put patient interests ahead of profits, preventing insurance companies from using the money for executive salaries or other overhead costs unrelated to dental services.
The Massachusetts Academy of General Dentistry 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, was one of the biggest funders of the initiative, committing $1 million to it, according to a boston globe report.
Delta Dental, the state’s largest dental insurance provider, covering more than 2 million people, has been one of the biggest opponents of the initiative, saying it could lead some insurers to raise premiums. The Boston-based insurance company argued that the initiative does not take into account all the costs that insurers face.
Former state senator James Welch of the Committee to Protect Public Access to Quality Dental Care told WGBH News that medical insurer requirements should not be imposed on dental insurers because dental coverage is not required in Massachusetts and has lower premiums to start with. 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 a exemption.
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If the initiative does not pass in November, no changes will be required from dental insurers. If the measure is approved by voters, it could spur other states to come forward with similar proposals.
