Mass. dental insurance overhaul signed into law by Sec. of State Galvin [masslive.com]

MassLive.com

Dental insurance in Massachusetts could change dramatically in 2024 after Secretary of State William Galvin signed a regulation overhauling premiums into law.

Bay Staters last month overwhelmingly passed Ballot Question 2, which requires dental insurance companies to spend 83% of premiums on patient care, rather than on administrative expenses, taxes or profits. If carriers spend less than 83 cents on every dollar of monthly subscriber premiums — a threshold known as a loss ratio — they must send rebates to insured individuals and groups.

More than 1.6 million people voted in favor of the referendum, with about 670,000 people opposing it.

Galvin, joined by members of the Massachusetts Dental Society, on Thursday morning finalized the ballot measure by signing “A Law Relative to Regulation of Dental Insurance.” Galvin’s office described the statute as a “first of its kind,” saying it’s “considered a model for dentist groups nationwide.”

“Today’s certification of the overwhelming victory for patient premium dollars being spent on patient care was made possible thanks to the support from dental teams and consumer advocates here in Massachusetts and across the country,” Dr. Meredith Bailey, president of the Massachusetts Dental Society, said in a statement Thursday. “Together, we proved that we can achieve positive change for the dental profession and the patients we serve. The Massachusetts Dental Society looks forward to working with our partners on Beacon Hill to implement the consumer protections afforded by Question 2.”

A dental loss ratio echoes a commonplace standard for medical insurance. In Massachusetts, insurers must meet an 85% or 88% ratio.

Critics of the referendum, including Republican Gov. Charlie Baker, expressed concern about the uncertain ripple effects of instituting the 83% threshold for dental insurer carriers, such as patients possibly spending more for care.

“If I have dental coverage, is this going to affect where I can go to get coverage?” Baker asked during an October interview on GBH’s Boston Public Radio. “Is this going to change what I pay for my coverage? And is it going to change the relationship that exists currently between insurers and dentists that affects price?”

A neutral report on Ballot Question 2 from the Center for State Policy Analysis at Tufts University also probed into the dearth of information underlying the 83% figure.

“This ballot question is built on relatively thin information,” the report said. “It’s not clear whether dental insurers are currently close to — or far from — the proposed 83 percent requirement. Indeed, there’s no clear basis for the 83 percent figure, and imposing it would make us the only state with a fixed loss ratio for dental insurance.”