The American Dental Association is backing H.R. 1521, the bipartisan Dental and Optometric Care Access Act, which would limit insurers’ ability to set fees for dental services they do not cover.
The ADA submitted a statement ahead of a Sept. 15 hearing of the House Energy and Commerce Committee’s Health Subcommittee, during which the DOC Access Act was among 17 legislative proposals discussed. The bill would extend the same non-covered service fee protections already enacted in more than 40 states to self-funded plans governed by the Employee Retirement Income Security Act — closing an exemption that has allowed self-funded plans to override state-level dental insurance protections.
ADA President Richard Rosato, DMD, and Executive Director Nader Nadershahi, DDS, EdD, wrote in the statement that it is “unreasonable” for dental plans to set fees for services in which they have no financial liability.
A recent Government Accountability Office report was also referenced during the meeting. This report found that the three largest dental insurers in each state held a median of 66.8% of the group-market enrollment in 2024, with their combined share ranging from 38% to 98%.
Rep. Buddy Carter, R-Ga., also raised concerns about consolidation during the hearing, stating that the issue impacts healthcare accessibility.
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