Connecticut residents and a critical health care issue

Nearly everyone — 94% of Connecticut residents in the most recent statewide survey — believes Connecticut should require dental insurance companies to report publicly the percentage of premium dollars they collect that is spent on patient dental care and the percentage that goes to the insurer’s administrative overhead, executive salaries and marketing budgets.

In addition, 91% of Connecticut residents support the state imposing a limit on the percentage of the dental insurance premium that can be used for insurer’s administrative costs.

Currently, neither is required in Connecticut. There’s no limit on how much of patient premium dollars can be siphoned off from patient care to overhead, and no transparency on how premiums are spent. There is proposed legislation at the State Capitol that would change that, but inexplicably, some legislators are apparently uninterested in even providing the public with an opportunity to speak at a public hearing that would consider the proposal.

Here’s what they would likely hear if dental patients and dentists could share what’s happening now, and why change is needed and necessary.

As little as 40% of premiums paid by patients to dental insurers goes to patient dental care. As much as 60% goes to insurance company overhead. That is not only absurd, but it can also adversely impact patient health.

When dental insurance carriers keep most of the premium dollars rather than devote that money to patient care, they have an incentive to keep raising those rates — because they reap the benefits. Additionally, some patients may be less likely to visit the dentist when the cost of premiums are too high, and small businesses may become less likely to provide dental coverage at all. Both results undercut patient health.

Premiums ought to be affordable, and premium dollars ought to be devoted to patient care. It’s just that simple. Oral health is essential to one’s overall health, and left unchecked, seemingly small problems can worsen and adversely affect a person’s health significantly — and at greater cost.

Under the federal Affordable Care Act, at least 80% of medical premiums must go to patient care. What is needed is parity in how health insurance payments are treated, whether they are for medical insurance or dental insurance. That is fundamental consumer protection, in every patient’s best interest. The Connecticut proposal would accomplish that.

The legislative proposal here also would ensure transparency. Insurance companies would be required to disclose how dental insurance premiums are spent, revealing the percentage paid for dental care and the percentage retained by the insurance company. If an insurance carrier failed to invest at least 85 percent of premiums to patient oral health, the difference would be refunded to the patient.

In Massachusetts, a similar proposal last November earned 72 percent of voters in agreement that parity for their dental needs was essential. Connecticut residents deserve the same investment by insurance companies in their health.

Waiting any longer to establish parity and transparency in Connecticut will just mean taxpayers will pay more out-ofpocket unnecessarily, giving another year of premium dollars to insurance companies to spend however they wish. This could mean several hundred dollars per household going directly to support insurance companies rather than essential health care.

Last week, the legislature’s Insurance Committee held a public hearing, but this proposal was not on the agenda. In fact, there was only one proposed bill discussed, and the committee adjourned after about half an hour.

Two additional public hearings have been scheduled, on a total of eight bills. Again, the proposal to impose fundamental consumer protections, transparency and accountability on how insurers spend the premiums paid by individual dental patients or small business who pay for that coverage continues to be omitted. That denies the public a chance to be heard on a proposal with overwhelming public support.

Why? There is no public opposition to this proposed legislation. There is bipartisan support for parity to what exists in the medical insurance world. Why can’t Connecticut residents voice their opinion on this critical health care issue?

One would hope that common sense will prevail, Connecticut consumers will have an opportunity to weigh in on this important issue, and legislators will ultimately do what’s right and take action before the end of the current legislative session.

During COVID, we saw some insurers respond to consumers and policy makers. Many auto insurance policy holders, for example, received refunds because driving was curtailed significantly. Such action was reasonable and appropriate.

Spending patient premium dollars on patient care should be no less obvious. Insurers should support this proposal and legislators should make it law, sooner rather than later.