As president of the Illinois State Dental Society and a
pediatric dentist, I am thrilled to see that dental insurance reform
legislation is gaining traction in Illinois. With key reforms passing Illinois
House and Senate committees in recent weeks, we are one step closer to
providing our patients and their families with the dental coverage they need
and deserve.
One of the most frustrating challenges our patients and
families face is limited and sporadic dental insurance coverage. Many are often
surprised at the amount they are required to pay out of pocket, and this can be
especially true for children with various oral health treatment needs. We often
see insurance simply will not cover services that are widely accepted as the
standard of care.
I have seen firsthand the devastating effects of limited
dental insurance coverage on our patients and their families. Recently, I had a
young patient who required work on 12 teeth, but his insurance would not cover
general anesthesia. As a result, he had to endure four visits, and each time
both the boy and his mom struggled in tears. It was heart-wrenching for him,
his family, and our staff, who could see the emotional toll it was taking on
everyone involved.
Dental insurance barriers like this are not just an issue of
inconvenience; they can have a real and lasting impact on our patients' health
and quality of life.
Limited dental insurance coverage has had a detrimental
impact on patients and their families for far too long, especially for those
who cannot afford high out-of-pocket costs. Necessary procedures are often not
covered or are severely restricted, leaving patients to shoulder the burden of
costly out-of-pocket expenses or delay critical oral care. All the while,
dental insurance companies continue to go unchecked, with up to 40% of patient
premiums going toward administrative costs that include extravagant marketing
and executive bonuses.
This is why the Illinois State Dental Society has launched
the More for Your Smile campaign, which advocates for reforms that remove
barriers to care and ensure that patients and employers get better value for
their money. The legislation removes barriers to care by requiring dental
insurance companies to direct at least 80% of patient premiums toward patient
care, ensuring patients and employers will get better value for their money,
and that out-of-pocket costs are reduced. It also puts an end to schemes used
by big insurance companies to gain additional revenue streams that hurt
dentists’ abilities to maintain financially healthy practices and ultimately
impact patient access to care.
The solution is clear. More patient premium dollars should
go toward patient care, not insurance companies. I am encouraged that lawmakers
in Springfield are considering reforms that could make a real difference in the
lives of patients across our state.
Patients can join these efforts to help give children and
families better access to the dental care they need and deserve by contacting
their lawmakers and urging them to support More for Your Smile legislation.
Help us send the right message to big dental insurance
executives: It's time to put patients first and ensure that dental insurance
coverage meets their needs, not the needs of insurance company profits.
Dr. Kenneth G. Rawson is president of the Illinois State
Dental Society.