The American Dental Association (ADA) has voiced support for new federal legislation aimed at closing a regulatory gap in dental insurance oversight.
The proposed Improving Dental Administration (IDA) Act, introduced by Jeff Van Drew and Herb Conaway, seeks to ensure that more than 360 state-level dental insurance reform laws apply equally to patients enrolled in self-funded plans.
Currently, these plans are governed by the Employee Retirement Income Security Act of 1974 (ERISA). Some insurance carriers argue that ERISA allows them to bypass state regulations designed to protect patients and providers.
ADA President Rich Rosato said the growing use of self-funded plans has enabled insurers to claim exemption from state oversight.
“The ERISA preemption has created a loophole that lets some carriers ignore state insurance laws,” Rosato said. “Patients and providers should not lose protections based on how dental benefits are structured.”
The ADA argues that the bill would eliminate this “gray area” by clarifying that self-funded dental plans must comply with state insurance laws. The measure would also strengthen the ability of state regulators to hold insurers accountable.
According to the ADA, confusion over regulatory authority has increased as employers shift from fully insured plans to self-funded models. This trend has raised concerns about inconsistent enforcement of consumer protection laws.
Rosato noted that ERISA was originally intended to regulate retirement plans such as pensions and 401(k)s—not to override state authority in healthcare coverage.
“Carriers should not use ERISA to sidestep reforms meant to protect patients,” he said.
If enacted, the legislation would restore greater regulatory clarity without affecting employer-sponsored retirement or benefit plans governed under ERISA.