Vote Yes on Ballot Question Two

This staff editorial is part of The Crimson Editorial Board’s 2022 Massachusetts Election Guide. See the full guide here.

Health is a human right.

We mean this in a literal sense: The right to health is, after all, enshrined in the international human rights corpus, and every country (including our own!) has ratified at least one international human rights treaty recognizing this right. However, we cannot achieve widespread societal well-being simply through our actions as individuals. If the Covid-19 pandemic has taught us anything, it is the absolute necessity for our government to protect the health of its citizens and residents through the provision of accessible, effective health care.

A functional society demands it.

Ballot Question Two answers such a demand by mandating that at least 83 percent of a dental insurance company’s revenue be used to cover claims and improve health care — or, in insurance-speak, a minimum medical loss ratio of 83 percent. If dental insurance companies fail to meet this minimum MLR, they will be required to refund the excess premiums to those paying for coverage.

The ballot question is endorsed by both the Massachusetts Dental Society and the American Dental Association, with dentists noting how it has the potential to improve health equity and the quality of dental care for patients.

Currently, Massachusetts has no regulations on the dental insurance MLR. Given the lack of publicly available data on the dental insurance MLR in Massachusetts, it is unclear how much of dental insurance companies’ revenue actually goes toward dental care, as opposed to administrative costs and profits. Passing Ballot Question Two will resolve this issue — not only by mandating a minimum MLR but also by making the data on this key measurement available to the public.

The establishment of a minimum MLR in the realm of health care is not a new concept. Under the Affordable Care Act, large health care insurance providers are required to spend at least 85 percent of their revenue on members’ care. In Massachusetts, which features some of the most rigorous MLR requirements in the nation, that number jumps to 88 percent for small-group health care plans.

We see no reason why minimum MLRs should exist in medical insurance and not in dental insurance. The split between dentistry and medicine in the United States is the product of historical conceptions which framed dentistry as craftsmanship rather than medicine, informing the exclusion of teeth from health care coverage in the 1960s and 70s. Applying regulations to dental insurance as they exist for medical insurance will reaffirm the importance of dental care and oral health as a necessary part of overall well-being; it will also increase accountability in the insurance industry more broadly, with the potential for nationwide reform.

Opponents argue that based on a study commissioned by the National Association of Dental Plans(which, it should be noted, has donated almost $3,000 in opposition to the proposed law), passing Ballot Question Two will increase the cost of premiums by 38 percent. However, safeguards against such increases are already built-in: per the text of the bill, Massachusetts must block any unreasonable increases in premiums, such as those rising above the consumer price index. Additionally, a policy analysis team at Tufts concluded that, on the net, Question Two will likely have little effect on consumer costs.

We hesitate to say that consumer costs will not rise in a Question Two-less Massachusetts. Patients are already burdened under existing dental insurance plans, with costs leaning heavier on patients year after year. Considering this downward spiral, one study commissioned by detractors that affirms the already-expected trend of cost increase is not enough to reject Ballot Question Two.

Opponents may also point to the contentious history of similar bills: The Massachusetts legislature adopted MLR reporting requirements in 2010, before repealing the act in 2012. As detractors note, no law like Question Two exists elsewhere in the nation.

If anything, this provides a reason to move forward with Ballot Question Two. Progress cannot always be linear: From the first American inoculation for smallpox to Romneycare as a precursor for nationwide Obamacare, Massachusetts has historically led health care progress in the United States. Ballot Question Two is another step down the long, and at times tumultuous, path to guarantee health as a human right. Massachusetts can continue leading the nation this fall: Vote Yes on Ballot Question Two.

This staff editorial solely represents the majority view of The Crimson Editorial Board. It is the product of discussions at regular Editorial Board meetings. In order to ensure the impartiality of our journalism, Crimson editors who choose to opine and vote at these meetings are not involved in the reporting of articles on similar topics.

Have a suggestion, question, or concern for The Crimson Editorial Board? Click here.