Opponents argue the measure, a 21-13 voting matter, would increase premium costs, reduce consumer choice and block access to dental insurance for the state’s most vulnerable residents, especially children. .
The question, if the signatures presented to Secretary of State William Galvin on July 6 are certified, would ask voters to approve a measure that would require dental insurers to spend at least 83% of insurance premiums on patient care, and if the money is not spent, coverage would be refunded to subscribers.
In Massachusetts, 88% of health insurance premiums must be used for treatment, otherwise the money is returned to the policyholder as a refund. This is called an annual overall medical loss ratio.
Extending it to dental insurance just makes sense, say supporters of the ballot question.
The two sides tussled in the shadow of the State House on July 6 when they made their case at a midday rally.
Dianne Morad, a lobbyist working with the Balloting Matters Committee, told the press conference that some large dental insurance companies are spending up to 40% of what they collect in premiums on “executive salaries , premiums and other administrative expenses” rather than on the patient care.
“A yes vote would help fix a broken system in which insurance companies benefit from denying claims and limiting coverage,” Morad said.
State Sen. Harriette Chandler, D-Worcester, has proposed a bill that echoes what could be included in the ballot question.
Dental health is essential to overall health, according to the Massachusetts Dental Society.
“Oral health plays a very important role in overall health,” with many systemic diseases indicated by oral health symptoms, according to the organization. Plaque, gum disease, missing teeth all contribute to other conditions, including lung problems, heart disease and stroke.
According to the Massachusetts Dental Society, pregnant women with gum disease are more likely to give birth prematurely. And low birth weight babies are more likely to have breathing problems, anemia, jaundice (yellowing of the skin due to liver problems), developmental delays and even congestive heart failure. . Teeth and gum problems can indicate diabetes and osteoporosis, a disease that affects some 10 million Americans, including 8 million women.
The Massachusetts Dental Society Board of Trustees approved the ballot question.
“As an advocate of dental care for all Massachusetts residents, the (Massachusetts Dental Society) endorses the Massachusetts Medical Loss Ratios initiative for dental insurance plans and encourages Massachusetts residents to adopt it by November,” said Dr. Meredith Bailey, president of the organization. “Patient dollars should be compulsorily spent supporting their oral health, and patients deserve to see how much of their dental insurance premiums pay for care as opposed to administrative costs.”
The measure would require dental insurers to disclose the projected medical loss ratio for their plans. It would also force them to anticipate base rates and file those fees by July. The measure would put approval of base rates in the hands of the state’s Insurance Division.
The Committee to Protect Access to Quality Dental Care – a coalition of dental plans, health plans, life insurers and professional associations organized against the ballot issue – said that he feared the measure would increase health care costs for consumers and small businesses.
“Supporters of this election issue are not being candid with voters,” the committee said. “What they’re not telling you is that their anti-consumer proposal will increase costs for Massachusetts families and employers – a nearly 40% increase in premiums in a recent study – and could prevent thousands of residents to have access to much-needed dental care.
A study commissioned by the National Association of Dental Plans examining the costs and benefits of the proposal found that most dental insurers in Massachusetts allocate between 60% and 79% of premiums to patient care, depending on company size. , with small firms allocating fewer dollars while large firms allocating more. The rest of the premiums billed are used, in part, for administrative costs.
The study, carried out by the Milliman Research Group, found that the proposal would affect companies with a smaller pool of customers. Additionally, meeting the 83% mandate, coupled with the cost of rebates, would tax the company’s revenue.
Opponents argue that a yes vote on the ballot issue in November could drive some dental insurance providers out of Massachusetts.
“With consumer prices reaching all-time highs, the Commonwealth does not need this additional regulation which will only increase costs and reduce patient choice statewide,” a committee statement said. of opposition.
The study predicts that premiums could increase by 38%, from $35 per month to $50.
State House News Service contributed to this report.