Repeal of the Antitrust Exemption for Health Care Insurance a Win for Consumers and Dentists

CHICAGO (Jan. 14, 2021)— “The Competitive Health Insurance Reform Act of 2020” was signed into law Wednesday after the culmination of a multi-year effort by several organizations, including the American Dental Association (ADA) to persuade Congress that health care insurance, including dental plans, should no longer be protected from some of the federal antitrust laws. The new law is aimed at improving transparency and competition in the health, dental, and vision insurance marketplaces.

The decades-long unfair protection of health insurers from some federal antitrust laws dates back decades due to a limited and antiquated exemption established under the 1947 McCarran-Ferguson Act. The new law makes the conduct of health insurers subject to more of the nation’s antitrust laws, like all other U.S. businesses, and helps remove additional obstacles to investigation and enforcement.

Since health insurers will now be subject to the same enforcement as other businesses, the ADA believes that both the Federal Trade Commission and the Department of Justice will be more likely to investigate alleged anticompetitive practices and activities of health care insurers.

“Over time, we will expect to see some changes in the dental plan marketplace that would benefit all,” said ADA President Daniel J. Klemmedson, D.D.S., M.D. “If dental plan companies are compelled to compete fairly and transparently, we should begin to see increased innovation and choice for consumers and providers as the dental plan market place changes over time.”

Dr. Klemmedson added that dental plan companies might look for ways to distinguish themselves by offering better levels of coverage, with lower premiums and reductions in copayments with expanded provider networks and services, and other improved features. Economic experts believe that the antitrust exemption suppressed the health insurance market dynamic. [1]

According to Dr. Klemmedson, the new law should also open up more opportunities for new insurance companies to enter the market to compete in offering better and more affordable coverage to consumers and better terms to doctors, hospitals, and providers.

“Ultimately, expanding choices under health and dental insurance plans will mean better plans for consumers, and improvements for health care professionals who seek to provide health care to patients within a more consumer-friendly framework," said Dr. Klemmedson.

[1] See Letters to House and Senate Judiciary Committees in support of Competitive Health Insurance Reform Act, June 5, 2019, available at https://advocacy.consumerreports.org/research/letter-to-house-and-senate-judiciary-committees-in-support-of-competitive-health-insurance-reform-act/

About the ADA

The not-for-profit ADA is the nation's largest dental association, representing 163,000 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 monthly The Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit ADA.org. For more information on oral health, including prevention, care and treatment of dental disease, visit the ADA's consumer website MouthHealthy.org