25 March 2026

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ADA Backs Legislation Protecting Dental Insurance Patients

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The American Dental Association (ADA) recently commended Rep. Jeff Van Drew (R-NJ) and Rep. Herb Conaway (D-NJ), for introducing the Improving Dental Administration (IDA) Act to ensure that the more than 360 state dental insurance reform/patient protection laws enacted in the last decade apply equally to enrolled patients of self-insured plans.

The Employee Retirement Income Security Act of 1974 (ERISA) regulates “self-funded” dental plans. Some dental carriers claim ERISA allows them to ignore state insurance laws meant to protect patients. The ADA wants to close that loophole and bring the power to regulate healthcare back where it belongs – with the states.

“The growing number of ‘self-funded’ plans regulated by ERISA has emboldened carriers to assert they are not subject to state oversight, claiming that the ERISA preemption gives them a free pass to ignore insurance laws,” said Rich Rosato, D.M.D., president of the American Dental Association. “We need to fix this ERISA loophole that keeps state regulators from enforcing pro-consumer insurance laws enacted in their states. Patients and providers should not be left unprotected based simply on how their dental benefits are purchased.”

This federal reform measure is necessary to address the “gray area” created by ERISA and to reassert states’ rights to regulate coverage offered in their state insurance market. Congress can clarify this ambiguity through legislation that would allow states to apply state passed legislation to ERISA plans. If this bill becomes law, it will make it clear that self-funded dental plans must adhere to state dental insurance laws.

“Insurance regulators are uncertain about how to hold carriers accountable to laws in their state when the carriers act as administrators for self-funded plans. This legislation takes a big step forward in creating fairness and accountability across the board,” said Dr. Rosato.

To date, there have been more than 360 insurance reform laws specific to dental care that have been enacted by states to protect patients and providers from abusive practices by insurers and third-party administrators. The continued growth of “self-funded plans” over “fully insured plans” and confusion over which laws carriers must abide by has prompted the ADA to seek federal legislation to address this confusion.

“ERISA’s original intent was to protect retirement plan assets like 401k, 403b or pensions,” said Dr. Rosato. “It wasn’t meant to let carriers ignore state laws and weaken consumer protections. We want carriers to follow the law and stop claiming ERISA as a reason to ignore the insurance reform efforts within our states.”

ERISA also regulates plan administrators and establishes minimum standards for pension plans and private industry. This legislative fix would not impact those employer-sponsored benefits.

About the American Dental Association 

The not-for-profit ADA is the nation’s largest dental association, representing 159,000 dentist members. The premier source of oral health information, the ADA has advocated for the public’s health and promoted the art and science of dentistry since 1859. The ADA’s state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer dental care products. The Journal of the American Dental Association (JADA), published monthly, is the ADA’s flagship publication and the best-read scientific journal in dentistry.

Source: www.ADA.org