Yes on Question 2

Ballot Question 2 asks voters to create a law regulating dental insurance plans in Massachusetts. A yes vote would require dental insurers to spend at least 83 percent of premiums on member dental expenses and quality improvements, and would also require dental insurance companies to report financial information about their income and expenditures to the Massachusetts Division of Insurance. A no vote would reject these regulations and make no change in the law.

There a few key pieces to consider in this question, all of which carry their own implications. The headline regulation would require dental insurers to pay 83 percent of the premiums collected from policyholders on the care and services received by those policyholders.

Massachusetts already has such a minimum requirement for so-called medical loss rations when it comes to medical insurers, but not for dental insurers. That means there's no requirement for dental insurers to spend the revenue from premiums on reimbursements for dental procedures instead of, say, executive bonuses and commissions.

The measure would also require dental insurers to share financial information - like how much they collect in premiums and where they spend it - with state regulators. While this is a less-discussed aspect of the measure, it's a critical one. Without this information readily available to policymakers or the public, it's difficult to actually tell what the medical loss ratios are for carriers in Massachusetts, although there's anecdotal evidence to suggest it's quite imbalanced in certain cases. But we really don't know for sure at scale, and that's a problem - not just for ensuring insurance companies are treating their clients fairly but for the prospect of crafting rules and regulations to that end. Additionally, the measure would create a mechanism for the Commissioner of the Massachusetts Division of Insurance to block premium increases deemed excessive or unreasonable relative to benefits.

Frankly, the latter two, less-discussed components of this measure compel us to support it more than the fixed medical loss ratio rule.

Berkshire County has certainly struggled to attract enough dentists to adequately serve more rural areas, especially when it comes to access to pediatric dental services. Insurance reimbursement rates are often cited as a pressure against opening up shop in lower-population areas and accepting insurance often held by low-income folks. This measure could alleviate this dental pain somewhat, either by driving up reimbursements or preventing excessive premium increases - or by at least getting our arms more firmly around the problem with the data that could be mined from the Question 2's reporting requirements.

Dental insurers will likely adapt to the medical loss ratio requirements as ably as medical insurers did, but if the bolstered reporting were to suggest a tweak in the 83 percent figure, the Legislature can and should do so.

Speaking of the Legislature, this is a prime example of something that should have been handled by lawmakers before it was kicked to voters in a dense and technical ballot question. With that in mind, The Eagle endorses both a yes vote on Question 2 and a call for the Legislature to do its job instead of leaving it to the ballot box.