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CDA supports medical loss ratio ballot measure in Massachusetts

Measure could create national momentum; CDA commits $75,000 to campaign committee

October 05, 2022 993

Quick Summary:

CDA supported a ballot measure in Massachusetts – Question 2 – that passed in the November election and will require dental insurance companies to spend at least 83% of premium dollars collected on dental services, as opposed to using the money for administrative costs and executive compensation. This type of percentage requirement on insurance plans is called a medical loss ratio, and CDA has sponsored multiple pieces of MLR-related legislation over the past decade.

Update Nov. 9, 2022: Question 2 passes

Question 2, the Massachusetts ballot measure, passed decisively in Tuesday's election

Oct. 5, 2022: CDA is supporting a ballot measure in Massachusetts — Question 2 on the November ballot — that would require dental insurance companies to spend at least 83% of premium dollars collected on dental services, as opposed to using the money for administrative costs and executive compensation.

CDA has also committed $75,000 to the “Massachusetts Dental Care Providers for Better Dental Benefits” campaign committee, a joint effort of the Massachusetts Dental Society and American Dental Association. CDA joins several other state dental associations that have also made financial contributions to this campaign. 

This type of percentage requirement on insurance plans — called a medical loss ratio (MLR) — already exists nationally for medical plans (80% for small group medical plans and 85% for large group medical plans) but does not apply to dental plans. Dental plans in Massachusetts that do not meet the 83% requirement would have to refund the difference to patients.   

A win on Question 2 in Massachusetts would potentially set an important precedent and drive momentum for other states to pursue policy in this realm, holding dental plans accountable for providing value for the premium dollars they collect.

“As dentists delivering patient care, we often see dental plan companies pocketing premiums without providing enough of those dollars in actual patient care,” said CDA President Dr. Ariane Terlet. “Dental plans need to be held accountable for how they spend premium dollars and we’re very pleased to join in this important reform effort that would set a new direction.”  

CDA has a long history of working on the MLR topic, sponsoring multiple pieces of related legislation over the past decade. Those bills created a standardized MLR reporting structure for dental plans in California and provided greater transparency to dentists, patients, employer plan purchasers and policymakers on how plans are spending consumers’ premium dollars. A summary of recent CDA-sponsored dental benefits legislation is available.

Dental plans have strongly opposed efforts to create an MLR requirement in California, and with the lack of standardized, meaningful benefits across dental plans as exists with medical plans, policymakers in California have been hesitant to apply a percentage requirement across the dental plan market. CDA will be continuing our work to address benefit design standards for dental plans as part of our long-term goal of increasing the value and transparency of dental plans.  

Dental plans are opposing the Massachusetts measure and have already contributed several million dollars to the “No” campaign led by Delta Dental of Massachusetts.   

“We know the dental plans will do all they can to defeat this measure and avoid this precedent, so I encourage CDA members to consider helping individually as well in whatever way they can,” added Dr. Terlet.

Individuals can get involved in the ‘Yes’ campaign

Anyone, including individuals outside of Massachusetts, who wants to get involved in the “Yes” campaign or contribute financially can do so through the Vote YES on Question 2 website. Dentists and dental organizations are joined by a coalition of other supporters including the Massachusetts Nurses Association and the Massachusetts Senior Care Association. 

CDA will continue to keep members updated through the newsroom and weekly newsletter.