Give the public a chance to be heard on dental premiums
In Connecticut, when patients or their employers pay their medical insurance premiums, they are assured that at least 80 percent will be devoted to their medical care. Astonishingly, there is no such requirement for dental premiums.
As a result, as little as 40 percent of the dental premium dollars patients pay to insurers goes to dental care. The vast majority — as much as 60 percent — is retained by the insurance company for executive compensation, corporate profits and administrative costs.
That reality is unfair to Connecticut residents, and counterproductive to assuring oral health care, which is a vital part of overall health. The state legislature can change that this year; it is fundamental consumer protection. Scheduling a public hearing — which would allow Connecticut residents paying premiums to be heard on this proposal — is the first step to move the proposal to a legislative vote.
Currently, dental insurers are not even required to disclose how much of the dental premium actually goes to patient dental care. In fact, dental insurers can increase rates with no guarantee that any of the increase will go towards actual patient care. At the same time, insurers reduce reimbursements to providers. As a small-business owner, I am facing skyrocketing inflation, extreme shifts in employee compensation and supply costs that are four times higher than they were pre-COVID. Both patients and providers are suffering without this important piece of legislation.
Some suggest this concept is complicated, and want to leave the status quo in place. But it’s really not complicated, it’s common sense. More of dental premiums should be devoted to dental care. And the public should know exactly how insurance companies are spending their premiums. It happens for medical insurance already — it should happen in dental insurance, as well.
Recently in Massachusetts, a similar proposal received overwhelming support from voters — 72 percent agreed that parity for their dental needs was necessary. Connecticut
residents ought to have at least the same level of investment by insurance companies in their health as Massachusetts residents.
The proposed Connecticut legislation would establish a minimum level for patient premiums to be allocated to dental health care, reversing the current lopsided allocation used by insurance companies. It also calls for transparency and accountability — insurance companies would be required to disclose how dental insurance premiums were spent, revealing the percentage paid for dental care and the percentage retained by the insurance company. And 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 or their employers, whichever pays the premium.
Ask just about anyone what they think of as little as 40 percent of their premium going to their dental care, and understandably, the response is likely to be outrage. That’s particularly true when people realize that so much more of what they pay in medical premiums — as much as double — goes to medical care.
Patients should not have to struggle to pay increasing insurer premiums, only to find out that most of their money didn’t even go to their dental care — instead, it was retained by the insurer to insulate the company’s costs and profits.
Fixing the current uneven premium requirements is an attainable remedy with a multitude of benefits. Ensuring transparency and value in dental insurance will help to reduce out-of-pocket costs for dental patients, which will in turn make access to dental care more affordable, encouraging people to get the care that they, and their families, need. Every insured Connecticut household would be able to receive hundreds of dollars in more dental care, without any additional money spent, if parity for dental insurance is passed by the Connecticut General Assembly.
The legislature has yet to schedule a public hearing on this proposal (HB5813), which has been introduced at the state Capitol by Rep. Mary Mushinsky of Wallingford, the longest serving member of the House of Representatives.
A public hearing should be scheduled expeditiously, so our legislators can hear directly from their constituents — patients and dentists — precisely why parity between how medical premiums and dental premiums are spent is in the best interest of family budgets and public health. I urge every patient, every oral health care provider to demand that HB 5813 get the hearing it deserves so that residents can voice their opinion on this matter. Blocking this bill denies patients and small business their voice in Hartford.