Insurers Oppose Check on Dental Carrier Spending

Potential Ballot Question Draws Little Testimony

As lawmakers mull whether to step in to a ballot question campaign involving dental insurance company spending and profits, a health plans representative urged both legislators and voters alike to reject the measure.

An initiative petition that seeks to apply a profit limit on dental insurance companies similar to those in place on medical insurers came before the Health Care Financing Committee for a hearing Monday, ahead of a May 3 deadline for lawmakers to act on the question if they wish to stop its path toward November’s ballot.

The petition (H 4378) would require dental insurers to spend at least 83 percent of their dollars on “dental expenses and quality improvements, as opposed to administrative expenses,” according to its text. Carriers with medical loss ratios of less than 83 percent would be required to refund excess premiums.

Orthodontist Mouhab Rizkallah, who chairs the ballot question committee, described the measure last December as “protective.” He said medical insurers must pay at least 88 percent of the revenue they collect from premiums toward patient care but that a similar requirement does not exist for dental insurance providers, meaning that “patients have to fight for coverage, and often quit due to exhaustion.”

Jason Aluia of the Massachusetts Association of Health Plans was the only person to offer live testimony on the petition during the committee’s virtual hearing, where he asked that lawmakers and voters “reject the establishment of a mandated dental loss ratio as outlined in this bill.”

Aluia said dental plans have lower premiums than medical insurance but face similar fixed costs, so administrative expenses make up a greater share of their budgets.

“Since the administration of benefits and regulatory requirements are not variable costs, passage of this question would require dental plans to increase payments to dental providers in order to meet these strict [medical loss ratio] requirements, resulting in increased premiums for consumers and increased costs for businesses offering dental coverage to employees receiving those benefits,” Aluia said.

Rizkallah last year contributed $501,000 to the Committee on Dental Insurance Quality, and the committee has paid almost all that money to Woburn-based Ballot Access Management for signature-gathering.

If lawmakers do not act on the petition by May 3, backers will have until June 22 to collect their next 13,374 signatures and file them with local officials for certification.

A committee organized in February against the question, under the banner of the Committee to Protect Access to Quality Dental Care, has not reported any spending or fundraising so far.