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Dental loss ratios are a loss for all West Virginians

Register-Herald (West Virginia)

By Daniel Croley, DMD, Vice President and Chief Dental Officer for Delta Dental of California

In their Jan. 20, 2023 Register-Herald opinion piece, “Hold Dental Insurers to a Higher Standard,” guest columnists Travis Willis and Dan Carrier got it half right and half wrong.

It’s true that many Americans delay getting the dental work they need due to burdensome costs. It’s false, however, to blame dental insurers for that when according to a study published in the American Journal of Public Health, people with dental insurance are more than twice as likely to get dental care as those without. In other words, dental insurers are the solution, not the problem in promoting access to dental care. What is more alarming is that the authors urge support of counterproductive legislation that will raise dental premium rates, which in turn will only increase the number of West Virginians and West Virginia companies no longer able to afford dental insurance.

The so-called “Dental Insurance Transparency Act” purports to reign in excessive insurer profits. Just one thing about that. There is no evidence of dental plans making excessive profits. The average dental insurer earns just two to three cents on every premium dollar charge. That is a significantly smaller margin than most businesses, and the return to customers who do have dental insurance is significant. It is well documented that individuals with dental insurance pay consistently less out of pocket for care, have decidedly fewer oral health issues, receive more consistent higher quality care and are spared many of the long-term negative health outcomes associated with poor oral health.

By imposing what is called a “loss ratio” on dental insurers, the “Transparency in Dental Act” will directly result in increased premiums, meaning the only thing this proposed bill will reign in are the services dental insurance plans provide that deliver the care and service West Virginians need.

When something seems too simple, it often is. A recent independent actuarial analysis looking at the potential impacts of dental loss ratios in the state of Massachusetts suggested they could have the following unintended impacts:

  • Increase most small group and individual dental premiums between 38 and 60 percent, making dental insurance less affordable and leading individuals and employers to drop their current dental policies. 
  • Push more businesses to self-insure, removing their dental benefits from state regulatory oversight.
  • Result in a market consolidation among dental plans, thus reducing consumer choice and options to purchase dental insurance.

Keep in mind that loss ratios should be considered in their original context – Medical plans were assigned minimum loss ratios in the Affordable Care Act (ACA) due to that Act’s substantial tax credits, which are intended to increase the affordability of those health plans to millions of low-and middle-income Americans. Health plans received significant enrollment in exchange for this requirement. Adult dental insurance was not deemed an essential health benefit in the ACA.

The bottom line is that loss ratios will raise dental premiums, which is counterproductive to increasing access to quality care and improving oral health for West Virginians. If you value your current dental benefits, or believe expanded access to dental care for more West Virginians is important, please speak to your elected officials and local representatives and urge them to not support the “Transparency in Dental Act.”

(This op-ed appeared in West Virginia’s Register-Herald on Feb. 25, 2023).