Voters in Massachusetts are being offered the chance this election to decide if dental insurance companies should spend a certain percentage of their monthly premiums on patient care, similar to rules already set up for medical insurance.
If approved, ballot Question 2 would make Massachusetts the first state to introduce a uniform rule for a “medical loss ratio” for dental insurance. It would also introduce other new rules for dental insurers in the state, including expanded financial reporting.
The question has largely pitted dentists against insurers.
Supporters of the question say the changes will mean patients will pay less and get more at the dentist office. Meanwhile, opponents say approval of the question will mean increased costs for patients and employers.
What would Question 2 do?
The biggest element of Question 2 is that it would establish a “medical loss ratio” — the amount of premium dollars a dental insurer must spend on patient expenses and care improvement instead of administrative expenses — of 83 percent. That means that dental insurers would be required to direct 83 cents of every dollar collected in premiums toward patients’ care. The remaining 17 cents of every dollar could be directed toward administrative costs.
As it stands, there is no minimum threshold for how much of premiums dental insurers must direct toward patient care.
Loss ratios are already used for health insurance, with insurers required under the Affordable Care Act to spend at least 80 percent or 85 percent of premium dollars on medical care. In Massachusetts, medical insurers must spend either 85 or 88 percent of their monthly premiums on care.
Question 2 would require dental insurers who fail to meet the 83 percent to issue rebates to patients, refunding the excess premiums.
Self-funded dental insurers, essentially employers that manage their own insurance pool and are paying an insurance company as a third-party administrator, would be exempted from the required 83 percent loss ratio.
The other significant component of the ballot question is that it would require dental insurers to submit information about their “current and projected medical loss ratio, administrative expenses, and other financial information” to the state each year.
If Question 2 passes, the measures it contains would go into effect in 2024.
What does the ‘Yes on 2’ campaign say?
Mouhab Rizkallah, a Somerville dentist who originated the ballot question, told Boston.com that Question 2 “redirects the enormous waste and misappropriation of patient premium funds back to patients.”
He argued that what he called “surplus funds” will be directed back to patients as lower copays, lower premiums, and premium refunds.
“If this law passes, insured patients will pay less and get more at the dentist,” he wrote.
Rizkallah accused dental insurers of attempting to “trick the public via voter fear” with their argument that the measure could result in increased costs for patients. (The “no” campaign says that the question has been compiled without any expert