A new Massachusetts law is requiring dental insurance companies to issue dental rebates to over 100,000 consumers in the state after failing to meet the state's Dental Loss Ratio (DLR) standard.¹ 

This makes it the first state in the US to roll out an order like this; the move is part of a greater effort to reduce healthcare costs state-wide and hold insurance companies financially accountable. 

According to the ADA, "DLR requires dental insurance companies to pay a set percentage of premiums collected on patient care."² They are designed to provide more transparency when it comes to spending and protect consumers in the process. Without them, insurance companies could theoretically spend the unspent premiums on salaries or other company costs instead of putting that money back into patients’ pockets.² 

What prompted this law 

In November 2022, voters approved the Dental Loss Ratio law that “requires commercial dental insurers to spend at least 83% of adjusted premium revenue on patient care and certain quality improvement activities.” For plans that did not meet this requirement, a portion of the premiums was returned to individuals or groups. This law took effect on January 1st of last year.  

In a recent government-issued press release, Governor Healey said: “People deserve to know that when they're paying for health and dental insurance, their money is actually going toward care."¹

Insurance commissioner Michael Caljouw piggybacked off this statement, noting: “Our efforts will help families and small business owners across the Commonwealth at a critical time. These rebates are important parts of our overall strategy to root out wasteful spending and reduce costs.” 

The Massachusetts rebate totals roughly $14.5 million for both dental and healthcare. Six dental insurance companies (Blue Cross and Blue Shield of Massachusetts, Guardian Life Insurance Company, Harvard Pilgrim Health Care Insurance, Reliance Standard Insurance, Standard Insurance, and Starmount Life Insurance) owe $8.4 million to consumers enrolled in their dental plans. For those covered by individual or small employer health plans, $6.1 million will be returned by Harvard Pilgrim Health Care Insurance, Massachusetts General Brigham Health Plan, and UnitedHealthcare Insurance.1 

However, the amount of money consumers receive will depend on their insurance premiums and carriers. 

Why this matters outside of Massachusetts 

Healthcare is widely unaffordable for many people in America—especially for low-income individuals. Even for those with coverage, costs remain high. On average, a patient’s out-of-pocket spending can be as high as $887 per person. Something to keep in mind is that this rate is compounded with the premiums patients pay towards health insurance.

Additionally, Medicare offers no comprehensive dental benefits. And even though Medicaid covers pediatric dental care, adult coverage ranges state by state, therefore creating sweeping care disparities depending on where patients live.³ 

Other state-wide relief initiatives 

Although it was the first, Governor Healey’s enforcement of this initiative may be paving the way for other states to follow. Several other states are currently offering or working on providing other forms of relief, including: 

Illinois: Governor JB Pritzker signed the Ins-Dental Coverage Reimbursement Act into law, which is designed to improve the reimbursement process by providing dentists with greater control over how they receive payments from insurers and dental plans.

Wisconsin: Enacted legislation that limits insurers' exclusive use of virtual credit cards, thus helping dentists have a bigger choice in how they receive claim payments. 

Mississippi: Enacted a new law requiring dental insurers to report the percentage of premium dollars spent on patient care. This is designed to create greater transparency for employers, consumers, and dental policymakers.⁴ 

References

1. Massachusetts orders $8.4 million in dental insurance rebates under loss ratio law. Anderson O. ADA News. August 10, 2026. https://adanews.ada.org/ada-news/2026/august/massachusetts-orders-84-million-in-dental-insurance-rebates-under-loss-ratio-law/  

2. Dental loss ratio (DLR). American Dental Association.  https://www.ada.org/resources/practice/dental-insurance/dental-loss-ratio  

3. Mind the gap: Bridging the oral health divide for more affordable and accessible coverage. Families USA. March 24, 2026. https://www.familiesusa.org/resources/mind-the-gap-bridging-the-oral-health-divide-for-more-affordable-and-accessible-coverage/  

4. State dental insurance reforms continue momentum in 2026 legislative sessions. ADA News. July 16, 2026. https://adanews.ada.org/ada-news/2026/july/state-dental-insurance-reforms-continue-momentum-in-2026-legislative-sessions/