The concept driving the much-needed reform is straightforward: dental patient premium dollars ought to be spent on patient care. The formal statement of purpose in proposed legislation at the State Capitol is succinct and unambiguous: “To establish the same medical loss ratio for dental insurers as currently applies to medical insurers.”
The proposed legislation (HB 5813) would ensure that the percentage of consumers’ insurance premiums that are applied to patient care – and not bureaucratic and administrative overhead – would be no different for dental care than medical care.
Surprisingly, that is not true today. In fact, the percentages are vastly different. For medical coverage, at least 80% or 85% of patient premiums must be devoted to care, in accordance with the Affordable Care Act. For their dental insurance coverage, consumers have no such protections – meaning that a much greater percentage of patients premiums could – and often do – go to insurance company expenses rather than the care and treatment they receive at the dentist’s office.
When one considers that oral health is an indispensable aspect of overall health, it is counterproductive to have patients pay for things other than what’s important to their health – especially at a time when costs are rising all around us and many families are deciding what they can afford and what’s just out of financial reach.
Plainly put, there ought to be a law requiring a minimum amount of dental premiums to be spent on patient care. The result would be better dental benefits for patients, greater transparency and accountability, and more families empowered to seek the dental care they need.
The existing disparities risk compromising patient health. It is time for parity, and consumer protections. Patients should not be left to wonder how much of their money