Question 2 could mean changes to your dental insurance

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A ballot question initiated by a Somerville orthodontist will either result in better dental health for about 25% of Massachusetts residents without dental insurance – or result in higher premiums and cause employers to drop coverage for their workers.

Question 2 of the Nov. 8 ballot “would regulate dental insurance rates by requiring companies to spend at least 83% of premiums on member dental expenses and quality improvements instead of administrative expenses and by providing ‘other amendments to the dental insurance regulations’. Additionally, insurers would be required to disclose where these premiums are spent.

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One in four insured Mass residents have no dental coverage

Under state law, Massachusetts residents are required to have health insurance. The Massachusetts Health Insurance Survey found the uninsured rate in 2021 to be 2.4%, compared to the national rate of 9.2%. Health insurers are required to allocate 88% of premiums to coverage. The proposed measure to change dental insurance was designed as an effort to reflect medical coverage for patients across the Commonwealth.

In contrast, a 2017 survey estimated that one in four state residents who have health coverage have no dental health insurance. In Massachusetts, 16.6% of all residents reported an unmet need for dental care due to cost in 2019.

“Even though dental insurance is less expensive on a monthly basis, the number and types of claims that arise in a typical year do not require the staff work that healthcare does,” Chris Keohan said. , co-founder of Shawmut Strategies Group, who worked in support of Question 2.

“Health care is clearly much more complicated when it comes to testing and trying to find the problem and the different treatments. There is a wide range of treatments. With dental care, it’s pretty standard pricing across the board. »

What fans say about question 2

Proponents say adopting Question 2 would result in lower premiums and denials of service, while covering more annual patient costs. Patients would also know how their premiums are being spent – ​​information that is currently not made public to those who sometimes pay large sums in dental insurance.

According to Question 2, fewer patients would be placed in “emergency” status in order to pay for their dental care, which state Rep. Jon Santiago, D-Boston, sees regularly as an emergency physician at Boston Medical. Center.

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“For someone who has an abscess in their mouth, if they wait too long it gets infected. It could have been something that would have been fixed if they had gone to the dentist, but now they are at the point where they have to go to the emergency room for medication and services,” he said.

Such situations occur more frequently because, once in an “emergency” state, the patient’s health insurance covers the costs.

“Really, it’s very simple: it’s important to make sure that people who pay dental insurance premiums, that the money goes to dental care and that as little as possible goes to overhead,” says the rep. Steven Owens, D. -Watertown, said in a phone interview. This hasn’t been the case for almost as long as dental insurance has existed.

Question 2 is supported by the Massachusetts Dental Society and 13 Massachusetts legislators.

What Opponents Say About Question 2

Dental insurers oppose it.

Opponents warn that premiums could rise by as much as 38% and thousands of Massachusetts residents could lose their dental coverage as a result. The study that predicted this price increase was commissioned and funded by a professional group of dental insurers.

“You’ll most likely see some carriers exiting the market and some carriers offering less in terms of benefits,” Jim Welch, a former state legislator and spokesman for the “No on 2” campaign told WBUR. “As carriers leave the market and the benefits go down, access goes down, quality goes down and, unfortunately, costs end up going up.”

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Welch said the measure, if passed, would disproportionately hurt those who can least afford it: “This election issue would really negatively affect small insurance companies, the ones that probably provide dental insurance to employers, small mom and pop type organizations.”

Kyle Sullivan, spokesperson for the Committee to Protect Access to Quality Dental Care, expressed similar concerns.

“Issue 2 will increase costs for Massachusetts families and employers and may result in thousands of residents being denied access to much-needed dental care. 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,” Sullivan said in a statement. on behalf of the committee.

Dental coverage is a voluntary benefit, leaving far fewer residents covered compared to mandatory medical insurance. Dental plans then have to spread the costs among fewer policyholders, Sullivan said, but dental plans have fixed administrative costs similar to medical plans, such as accreditation and monitoring for fraud, waste and misuse. abuse.

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“Dental insurers have fewer dollars and fewer policyholders to cover administrative expenses,” Sullivan said, “and so those expenses include a larger portion of dental premiums than medical premiums.”

Delta Dental, the state’s largest insurer, has contributed more than $4 million to the Question 2 opposition effort, according to Massachusetts Office of Campaign and Political Finance data through Oct. 1, a reported WBUR.

The Massachusetts Dental Society had donated more than $200,000 to the “Yes on 2” campaign, and the American Dental Association had pledged $5 million. Mouhab Rizkallah, the Somerville orthodontist, is the largest individual donor, contributing more than $2 million. Several dozen donations came from individual dentists, mostly amounts in the hundreds.

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