Opponents of a proposed ballot question that would cap dental insurers’ profits on Monday have asked the state’s highest court to disqualify it, arguing that it improperly combines expansive reporting mandates with expense breakdown requirements.
In a case that could determine whether voters have the final say on possible new insurance regulations, a lawyer seeking the derailment of the petition tells the Supreme Judicial Court that it fails the ‘nexus’ test which prevents voting questions from combining disparate topics.
The text would require dental insurers to spend at least 83% of their premiums on “dental expenses and quality improvements, as opposed to administrative expenses”, a so-called medical loss ratio designed to limit the amount of money patients that insurance companies pocket for themselves. Another section requires insurers to submit annual financial statements to state regulators that would cover other types of insurance beyond dental coverage.
Tad Heuer, a Foley Hoag attorney representing the two registered voters who challenged the potential issue, said Monday that the more detailed reporting requirements target information unnecessary for the state to review and enforce a profit cap on insurance. dental.
“They need extensive, entity-wide insurance data that goes far beyond just dental insurance,” he said.
Attorney General Maura Healey certified the proposal and allowed it to move forward to the November ballot, and her office argued in court that imposing broader data reporting would struggle with “ripple effects potential” from the imposition of profit limits.
“This prevents them from shifting overhead from dental insurance to disability or life insurance in a way that would inflate other overhead lines while simultaneously reducing the overhead shown in dental insurance,” said said Assistant Attorney General Adam Hornstine.
The SJC surveyed attorneys representing Healey, plaintiffs and the issue’s main backer on whether financial data would help better inform regulators in their oversight of dental insurers. Judge Dalila Argaez Wendlandt said: “Isn’t it important to know where you have been, where you are and where you are going in order to determine whether the rate change is appropriate?”
“I understand that there is something very useful in requiring insurance companies to produce all their financial data. It is useful, but I do not understand either – it seems to me a very different proposition from dental rate oversight,” Judge Scott Kafker said, asking whether the question would force voters to consider “two potentially good, but distinct ideas.”