Press Release: 2022-09-22

Massachusetts Question 2: Should Voters Approve New Rules for Dental Insurance?

Massachusetts Question 2: Should Voters Approve New Rules for Dental Insurance?



Center for State Policy Analysis analyzes the potential impact of “yes” and “no” votes

FOR RELEASE: September 22, 2022, 10 am

CONTACT: Robin Smyton, Assistant Director, Media Relations | 617-627-5392

report released today by the Center for State Policy Analysis (cSPA) at Tufts University's Jonathan M. Tisch College of Civic Life looks at the Massachusetts ballot question requiring that 83 cents of every dollar dental insurance companies collect in monthly premiums is spent on patients' dental care.

This 83 percent standard is referred to as the "loss ratio." While such loss ratios are common in the medical world, Massachusetts would be the first state with a matching rule for dental insurers.

"Some ballot questions test voters' core values," said Evan Horowitz, executive director of cSPA. "Others, like this one, ask voters to make pretty technical decisions. In such cases, we aim to make the technical issues more approachable, while also giving voters the information they need to shape policy."

Today’s report — the second in a series that will examine all four questions on the November 8 ballot — describes how the 83 percent requirement would affect insurers and patients alike. Key findings include:

  • A lack of reliable information about the dental insurance industry makes this ballot question especially hard to assess. It's unclear whether dental insurers are currently lose to — or far from — this 83 percent requirement. Indeed, there is no clear or tested rationale for the 83 percent figure.

  • The available information suggests dental insurers could probably adapt to the 83 percent standard, just as medical insurers did with the similar standards set by the Affordable Care Act. Those most likely to struggle are the smaller, less efficient dental insurers.

  • To meet the 83 percent loss ratio, insurers could either cover a wider range of procedures or allow higher prices for individual dental services. Some price increases might then pass through to patients.

  • Question 2 also includes a number of reporting requirements that would shed useful light on the dental insurance market and allow for better-grounded regulations moving forward.


cSPA provides expert, nonpartisan analysis of legislative proposals and ballot questions in Massachusetts. It is based at Tufts University and guided by a bipartisan advisory group. cSPA is supported by Tisch College along with a diverse group of funding sources from across the political spectrum. These funders have no involvement in cSPA's research.