There are ballot questions awaiting Massachusetts voters in the general election on 8 November. Ballot questions are laws submitted directly to voters for approval, or disapproval, alongside the regular slate of candidates. 

Voters will discover four different questions on their ballot:

• Question 1: Millionaire’s Tax

• Question 2: Regulation of Dental Insurance

• Question 3: Expanding Alcohol License Availability

• Question 4: Driver’s License for Undocumented Immigrants

Question 2: Regulation of Dental Insurance

Q: What’s less popular than a trip to the dentist?

A: Reading the minutiae of a bill about trips to the dentist.

We’ll keep it to the point. The Secretary of State’s office summarizes the proposed amendment as follows:

“This proposed law would direct the Commissioner of the Massachusetts Division of Insurance to approve or disapprove the rates of dental benefit plans and would require that a dental insurance carrier meet an annual aggregate medical loss ratio for its covered dental benefit plans of 83 percent….”

Actually, the summary is much longer, but the point is that the proposed consumer protection law seeks to limit how much of your insurance premiums go to paying for dental care as opposed to ballooning administrative costs. If you have ever tried and failed to comprehend what you're getting back for all the money you spend on dental insurance (or worse, skipped regular dental appointments because premiums were too high), then you might have a dog in the fight on Question 2.

The SoS also passes along the following arguments for and against from proponents and detractors of the proposed amendment.

FOR

Dr. Patricia Brown, DMD, MPH

The Committee on Dental Insurance Quality

A YES vote expands consumer protection laws that already exist for medical insurance companies to dental insurance companies.

A YES vote ensures better coverage and value for patients, instead of unreasonable corporate waste. For example, according to its own 2019 Form 990, Delta Dental (in Massachusetts alone) paid executive bonuses, commissions, and payments to affiliates of $382 million, while only paying $177 million for patient care.

A YES vote would eliminate this inequity. Similar to medical insurance, this law would require dental insurance companies to allocate at least 83% of paid premiums to patient care, or refund premiums to patients to meet this standard.

Insurance companies will try to confuse voters by saying that dental insurance premiums will increase. This is false, because Section 2(d) of the law specifically disallows increases above the consumer price index without state approval.

Stop the corporate waste.

Vote YES for fair dental insurance.

HDN Comments:

What we need is one of those stats that toothpaste commercials always drop: “4 out of 5 dentists recommend…” We don’t have these numbers, but the American Dental Association supports the bill and is the top financial contributor. Why? It’s betting, on behalf of dentists across America, that dentistry (not to mention, America’s teeth) will benefit from some sort of check on the upward spiral of dental care costs to the consumer. Especially when these rising costs are associated with what the FOR side has termed “corporate waste.”

AGAINST

Louis Rizoli

Committee To Protect Public Access To Quality Dental Care

This question will increase costs for Massachusetts families and employers — a 38%-premium-increase in one recent independent study — and could result in thousands of people losing access to dental care. With consumer prices soaring, we don’t need a new regulation that will increase costs and decrease choice.

There is no law like this ballot question anywhere in the nation. The Massachusetts Legislature actually repealed a similar law in 2011 because it proved overly burdensome and provided no real benefits for consumers. Federal lawmakers excluded it from Obamacare, and a special commission in Massachusetts reviewed and rejected a similar provision. Further, the state already requires reporting from dental plans.

HDN Comments:

Lawyer and lobbyist Louis Rizoli suggests that the attempt to price control the costs of dental care will actually increase, rather than decrease, costs. Indeed, the attempt to tinker with the economy can have unexpected consequences. Rizoli directs us to one unnamed study that claims prices will increase by 38% if Question 2 is approved.

Verdict: Vote Yes on Question 2

It would have been nice if the AGAINST side was spearheaded by a dentist rather than a lawyer and professional lobbyist. But perhaps they couldn’t find a dentist willing to make this counter argument? While tinkering with prices can have negative unintended consequences, there are provisions in place (section 2(d) of the bill) to block the most undesirable of unintended consequences: increased cost to the consumer. By mandating that a minimum threshold of premium-generated revenue must be spent on patient care, rather than ballooning executive pay, the bill follows a consumer protection precedent already in place for medical insurance companies. It’s worth a try. For more, check out this breakdown by the Boston Globe.

Stay tuned for more analysis on the remaining ballot questions…