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More dental insurers spend to stop Question 2

The measure on November ballots would require insurers to spent at least 83 percent of premium revenue on patient care.

Dr. Andrew Tonelli DMD (left) works on milling a crown for his patient, Paul Convey, with the help of dental assistant, Sharon Tavares, at Dental Health Concepts in North Reading, Mass. on Oct. 24, 2022.Carlin Stiehl for The Boston Globe

Until this month, the opposition to a state ballot question requiring that a large share of dental insurance premiums be spent on care was almost entirely financed by one company: Delta Dental of Massachusetts.

It looks like the reinforcements have arrived.

Records filed with the state Office of Campaign and Political Finance by an Oct. 20 deadline show several other major insurance companies writing checks to defeat Question 2 on next month’s ballot. These donations bring the industry’s fund-raising from nearly $5 million up to roughly $7.5 million, to beat back a measure requiring dental plans to spend no less than 83 percent of the premiums they collect on patient care as well as imposing new financial disclosure rules. That’s more than many insurers spend now.

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MetLife gave $650,000 earlier this month, on top of $220,000 in May. Other insurers contributing this month to the Delta Dental-backed ballot committee included Altus Dental ($75,000), Principal Life Insurance ($250,000), and Sun Life Financial ($200,000). As with MetLife, Sun Life and Principal had given smaller amounts earlier in the year.

Principal also helped start a separate opposition committee, with another $580,000, along with $350,000 from MetLife, $500,000 from Guardian Life, and staff assistance from the American Council of Life Insurers.

Despite all the insurance industry dollars, the dentists and their trade groups who support Question 2 have raised even more: $9 million-plus so far, including $5 million from the American Dental Association. More than 300 dentists have now contributed, including dozens from other states; orthodontist Mouhab Rizkallah, the original filer of Question 2, is by far the largest individual contributor.

Dentists argue that more premium dollars will go to patient care if voters approve Question 2, while the insurers say patient care will be hurt by the new restrictions on their industry.

Jack Dolan, a spokesman for the life insurers council, said ACLI got involved because Question 2 “would make dental coverage harder to access for many employers and families.”

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And Sun Life spokeswoman Cynthia Michener said her company believes that imposing the 83-percent dental loss ratio would drive up costs for dental insurers. That, in turn, could cause some insurers to drop certain kinds of plans, or prompt them to leave the market entirely, she said, hurting patient access to dental care.

Meanwhile, the dentists argue that insurers can take a few different approaches to reach the 83-percent minimum such as reducing premiums, cutting back on administrative expenses, or providing greater coverage of procedures.

Andrew Tonelli, co-chair of the Massachusetts Dental Society’s government affairs committee, said if insurers do raise premiums to meet this new threshold, they would also have to increase benefits, probably at a greater pace.

“Right now, insurers have very little incentive to cover things,” said Tonelli, a dentist with a practice in North Reading, “[beyond] just enough to not have intense blowback from customers.”

He had anticipated that other insurers would pump more money into the fight to defeat Question 2.

“We always expected that the insurers were going to have deeper pockets that they could go to,” Tonelli added. “Being that it’s the home stretch here, it’s no surprise they’re going to reach into those pockets.”

For its part, Delta Dental did not add more funds to the “no” campaign in October, at least as of the most recent filing, though the insurer has been running a marketing campaign that does not mention Question 2. Tonelli said he thinks Delta Dental is using its marketing funds to curry the favor of voters, in advance of the Question 2 vote.

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The Charlestown-based nonprofit insurer maintains that the two campaigns are separate. Chief executive Dennis Leonard issued a statement on Friday saying Delta Dental’s “Express Your Health” campaign is part of Delta Dental’s ongoing effort to ensure that people understand the connection between oral and overall health, and to encourage them to visit dentists for preventative care, and is not related to Question 2.


Jon Chesto can be reached at jon.chesto@globe.com. Follow him on Twitter @jonchesto.