{ legislative & regulatory }


(DLR) — a patient-focused reform designed to bring greater transparency, accountability and value to dental insurance.


Revisiting Dental Loss Ratio A


Building momentum through “More For Your Smile campaign” in 2026 session by GRACE RILEY


s Missouri’s 2026 legislative ses- sion begins January 7, the MDA is again supporting legislation to establish a Dental Loss Ratio


patient care or issue rebates — to whomever pays the premiums, whether an employer or the patient — when they fall short. The goal is straightforward: to ensure that premium dollars are primarily used for dental care rather than excessive administrative costs or insurance profit.


DLR CORE PRINCIPLES


This marks the third consecutive year the MDA has pursued DLR legislation, building momentum, strengthening relationships with lawmakers and refining our approach. With new data from other states and the launch of a statewide patient engagement campaign, the MDA believes Missouri is well positioned to move this reform forward.


The MDA first introduced DLR legislation in 2024 to educate lawmakers and to lay the groundwork for progress. In 2025, the bill advanced to committee, but lawmakers requested additional real-world outcome data before proceeding. In 2026, the MDA is returning with that data — that the ADA has been compiling from states with en- acted DLR laws — to further strengthening Missouri’s case. We also have bill sponsors secured to prefile the legislation — early support that reflects the strong relationships MDA has built and the trust lawmakers have in our priorities.


WHAT IS A DENTAL LOSS RATIO


Under the Affordable Care Act, medical insurance plans are required to spend a minimum percentage of premium dollars on patient care — generally 85 percent for large group plans. Dental insurance, however, is classified as an “excepted benefit” and is not subject to the same standard.


A DLR would change that. Simply put, a DLR would require dental insurers to spend at least 85 percent of premium dollars on


16 focus | WINTER 2025 | ISSUE 4


While insurance policy can feel complex, the core principles behind DLR are simple:


• Medical insurance plans have followed minimum loss ratio requirements since 2011.


• Efficiently managed insurance plans can meet these standards and remain competitive.


• Insurers already track the data required to comply with a DLR.


• DLR creates transparency for regulators and the public.


• Transparency is a basic consumer pro- tection — not a burden.


• Over time, DLR improves insurance quality, patient value and accountability. In short, DLR aligns incentives so that dental coverage works the way patients expect it to.


LAUNCHING A PATIENT-FOCUSED CAMPAIGN: MORE FOR YOUR SMILE


A key difference this session is the MDA’s investment in a patient-centered advocacy effort. Too often, Missourians pay for dental insurance only to discover that coverage does not meaningfully support their dental care. That experience is familiar to dentists and dental teams — and it resonates with patients. To elevate those patient voices, the MDA is launching the More for Your Smile Missouri campaign. This initiative invites patients to join dental professionals in calling for dental insurance reform.


YOUR ROLE IN THE CAMPAIGN


To support this effort, the MDA has mailed a patient toolkit to all active practice loca- tions in our member database. The toolkit includes three easel-back posters designed for immediate display in high-visibility areas such as waiting rooms, checkout areas, and operatories.


The key feature and call to action of the post- ers is a QR code directing patients to an easy- to-use website where they can learn about DLR and send a pre-written message to their state lawmakers in less than a minute. No policy expertise is required — just a willing- ness to speak up.


As trusted healthcare professionals, dentists and dental teams play a critical role. Review- ing the talking points included with the post- ers and having brief, confident conversations with patients about why this issue matters can make a meaningful difference.


Additional practice resources — includ- ing materials for dental professionals to contact lawmakers — are available at MoreForYourSmileMo.com/Toolkit. The MDA team is also available to support your practice with questions or additional guid- ance.


Grace Riley is legislative liaison and lobbyist to the MDA, through Gamble and Schlemeier Governmental Consultants, MDA’s longtime lobby firm. Contact her at grace@molobby. com.


“This campaign matters because to advance this legislation, lawmakers must see that both dentists and patients support reform,” said Vicki Wilbers, MDA Executive Direc- tor. “Engagement by dentists and patients throughout the legislative session is essen- tial.”


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