--- title: How Massachusetts’ election could change dental insurance - The Hustle description: Health insurers have to spend a certain percentage of revenue on patient care. Dental insurers don’t. image: https://hs-sbup.thehustle.co/hubfs/The%20Hustle%20News/Assets/Images/585065150-HS-News-Brief_2022-11-04T000534.485Z.webp --- # How Massachusetts’ election could change dental insurance ![Juliet Bennett Rylah](https://53.fs1.hubspotusercontent-na1.net/hubfs/53/assets/hubspot.com/web-team/WBZ/HubSpot%20Media/Blog%202021/Images/Nav/Optimized/TheHustle_Icon_Dark.svg) [Juliet Bennett Rylah](https://hs-sbup.thehustle.co/author/juliet-bennett-rylah) [Juliet Bennett Rylah Twitter profile ](https://twitter.com/JBRylah) Published: November 04, 2022 Updated: October 11, 2023 Dental insurance is confusing, and not just because you need entirely separate insurance just for your mouth bones. ![How Massachusetts’ election could change dental insurance](https://hs-sbup.thehustle.co/hs-fs/hubfs/The%20Hustle%20News/Assets/Images/585065150-HS-News-Brief_2022-11-04T000534.485Z.webp?width=595&height=400&name=585065150-HS-News-Brief_2022-11-04T000534.485Z.webp) There’s also very little transparency into *how* insurers spend their money — something a [Massachusetts ballot initiative ](https://www.sec.state.ma.us/ele/ele22/information-for-voters-22/quest_2.htm)aims to change. #### **Some background** **Medical loss ratio (MLR) **is the [percentage](https://www.healthinsurance.org/glossary/medical-loss-ratio/) of premium revenue spent on medical claims and improvements to care, versus admin costs and profit. - Per the Affordable Care Act, US health insurers must meet a minimum MLR of **80%** or issue rebates to patients. - This year’s rebates are expected to total [~$1B](https://www.kff.org/private-insurance/issue-brief/data-note-2022-medical-loss-ratio-rebates/), or ~$128 per customer. Dental insurers [don’t have](https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.0441#:~:text=The%20Affordable%20Care%20Act%20(ACA)%20requires%20large%2Dgroup%20health,spend%20at%20least%2080%20percent.) minimum MLRs, and only California and [Maine](https://insurancenewsnet.com/innarticle/mass-ballot-initiative-may-represent-start-of-nationwide-dental-insurance-reform) require annual reports — so we don’t even know most insurers’ MLR. #### **Massachusetts’ Ballot Question 2…** … would set a minimum MLR of 83% for state dental insurers, *and* require them to [share](https://www.boston.com/news/politics/2022/10/20/2022-massachusetts-elections-question-2-dental-insurance-regulations/) financial data. If passed, it would be the first such law in the US. **In favor: **[Dentists](https://fairdentalinsurance.org/endorsements/). “It’s a baseline protection,” Dr. Andrew Tonelli, spokesperson for Massachusetts Dental Care Providers for Better Dental Benefits, told *The Hustle*. “If a patient walks into my chair and they have dental insurance, I can at least rest assured that they’re getting a reasonable deal.” - The Committee on Dental Insurance Quality [asserts](https://ballotpedia.org/Massachusetts_Question_2,_Medical_Loss_Ratios_for_Dental_Insurance_Plans_Initiative_(2022)) that in 2019, the state’s largest insurer, Delta Dental, paid **$382m** in exec bonuses, commissions, and payments to affiliates, compared to** $177m** on patient care. **Opposed:** Dental insurers, who [claim](https://www.wbur.org/news/2022/10/18/massachusetts-ballot-question-2-explainer) premiums would increase as much as 38% (citing a study commissioned by a trade group for dental insurers). An [analysis](https://voteyeson2fordental.com/wp-content/uploads/2022/10/Tufts-Center-for-State-Policy-Analysis_Question-2-New_rules_dental_insurance.pdf) by **Evan Horowitz**, executive director of Tufts University’s Center for State Policy Analysis, found that Question 2 likely wouldn’t transform insurance, and that any price increases would be minimal. But, he [told](https://www.boston.com/news/politics/2022/10/20/2022-massachusetts-elections-question-2-dental-insurance-regulations/) *Boston.com*, the financial reporting would help us understand the market and inform “future laws around solving problems for patients and participants.” Topics: [Insurance](https://hs-sbup.thehustle.co/tag/insurance) ## Follow us on social media Pop up for Subscribe to The Hustle Daily Newsletter Subscribe to The Hustle Daily Newsletter Get the 5-minute news brief keeping 2.5M+ innovators in the loop. Always free. 100% fresh. No bullsh*t. 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