37 dental insurance reform laws passed in 2025

Thirty-seven new dental insurance laws have been enacted in 18 states this year, as of press time. In most instances, the ADA’s State Public Affairs program provided grants to dental societies that directly supported the advocacy activities leading to the successful passage of these new laws.  

More than 120 unique legislative proposals were filed, with several reform initiatives wrapped into a single bill. One proposed law that would have repealed the requirement that insurers pay equal reimbursement to non-network dentists was rejected in Texas, bringing the total number of successes in legislatures to 38 so far.  

The most common issues in this year’s legislative season include dental loss ratio, virtual credit cards, assignment of benefits and provider credentialing process improvements. The ADA News also provided an overview of states that enacted dental benefit legislation in 2024 and an update earlier this year on states that specifically enacted dental loss ratio bills.   

In 2025, 15 states filed bills establishing a dental loss ratio requirement – which refers to the measurement of insurance premiums spent on dental care rather than overhead. These bills ranged from requiring insurers to meet a minimum annual expenditure percentage of premiums, to reporting the percentage spent on care, to studying the issue with an intent to establish a minimum spending percentage requirement. So far, three dental loss ratio bills have been enacted this year, in Montana, North Dakota and Washington.   

Eight of the 12 states filing a virtual credit card bill were successful. These include California, Maine, North Dakota, Oklahoma, Utah, Virginia, Washington and Wyoming. Most of the new laws established the requirement that insurers both inform dentists of fees associated with accessing claim payments and ensure dentists have other non-fee related payment options. Several states amended their existing laws to broaden the reach of the law and lock dentists’ elections in place so insurers could not default back to virtual credit cards if the dentist opts out. States are trending toward adopting opt-in provisions that require dentists’ approval before insurers can pay claims using virtual credit card. The latest success in California requires affirmative consent from the dentist before insurers can use a fee-based payment method. The new law also requires insurers to associate with each payment the details associated with claim payment. Dentists may opt in or opt out at any time. 

Max Martinez, D.D.S., president of the California Dental Association, said the association is dedicated to pursuing dental plan reform for the betterment of both patients and providers.   

“Dental plan challenges remain a significant concern for our members because of the disruptions they cause to treatment plans and patients’ ability to receive the care they need,” Dr. Martinez said. “At [the California Dental Association], we’re committed to doing everything we can to hold plans accountable and to advance meaningful standards and protections that pave the way toward dental coverage that works for both providers and their patients.” 

Additionally, of the eight states considering assignment of benefit bills, three have successfully enacted the legislation. They include Illinois, Kentucky and Nevada. Assignment of benefits, which requires dental insurance companies to pay dentists directly for rendered services regardless of network participation status, aims to preserve patient choice and foster greater access to care for patients.  

Twenty states introduced bills regulating artificial intelligence in claim payment adjudication, which generally works to ensure human participation in the payment process, making this issue the most robust issue in the insurance reform arena this year. Concerns over too much claim processing automation prompted legislators to consider laws that ensure human reasoning would remain part of the claim payment process. Twenty states introduced artificial intelligence bills this year, with at least two passing into law: Arizona and Maryland.  

Among the 18 states that passed significant dental insurance legislation were Washington, North Dakota and Texas. With House Bill 5351, Washington’s dental loss ratio reporting laws will now ensure only payment data in Washington state is used to report state dental loss ratio percentages. Prior to the new law, insurers reported dental loss ratio data as required by the state but included data from outside Washington, which skewed the financial reporting. It also requires the state to conduct a collaborative forum with participation from stakeholders – including the Washington State Dental Association – on dental loss ratio and relative payment for dentists based on their participation status. Washington also passed virtual credit card protection legislation in the same bill, which requires dental insurers to notify dental providers in advance of paying claims with a virtual credit card as well as offer alternative payment methods that do not impose fees.  

Bracken Killpack, executive director of the Washington State Dental Association, said the association’s success in passing this legislation was due in part to ramping up advocacy efforts over the last few years. The organization launched an “aggressive” and “proactive” lobbying communications effort that was buttressed by strong grassroots engagement from members contacting legislators. Mr. Killpack noted that the bill passed without a single “no” vote at any step in the legislative process.  

“While we are encouraged by the progress we made this session, there’s still more important work to be done. We look forward to continuing our campaign in the coming year. Our patients and our members deserve better,” he said.  

North Dakota passed four new laws this year. The association advocated for — and helped successfully pass — dental loss ratio minimum percentage requirements, prohibition on insurers’ ability to both deny payment while simultaneously prohibit billing patients, and virtual credit card dentist protections. North Dakota also enacted a joint contact negotiation law, Senate Bill 2375, which leverages a federal safe harbor provision that allows dentists to join together on a limited basis to collectively negotiate with insurers on certain non-financial contract provisions. 

With House Bill 1052, Texas added a requirement that health insurers must cover telehealth services provided across state lines if the patient lives in Texas and the provider has an office in the state. It also passed Senate Bill 527, which prohibits health benefit plans that provide coverage for general anesthesia from excluding coverage for medically necessary general anesthesia services in connection with dental services provided to young enrollees or patients unable to undergo treatment without general anesthesia due to a documented reason. Additionally, due in part to advocacy from the Texas Dental Association, House Bill 335 was killed. This legislation would have repealed existing law requiring payment or reimbursement for noncontracting dentists to be the same as payment or reimbursement for in-network dentists.  

For more information about dental insurance reform, visit ADA.org/dentalinsurance.