On January 10, a group of WSDA representatives, including both WSDA Board members and our advocacy team, met with representatives of Delta Dental of Washington (DDWA) and the Office of the Insurance Commissioner (OIC).

This meeting was an opportunity to lay out for our newly elected Insurance Commissioner Patty Kuderer, and other OIC leaders, the key points of our robust dental benefits reform legislation.

During our meeting, we had a vigorous conversation regarding ways in which DDWA's anticompetitive behaviors are hurting patients. Here’s a summary:

• We discussed how DDWA leverages its dominant market position (which controls over 90% of some markets in our state) to punish patients and dentists. In recent months, several DDWA leaders have proclaimed that its network of contracted dental offices is its “competitive advantage” in the market. We believe the phrase “anticompetitive advantage” is a more accurate term to describe DDWA’s punitive tactics, given its market dominance.
• We explained that, unlike its competitors, DDWA leverages its dominant market position to pay a significantly below-market non-network reimbursement rate for patient care provided by dentists not contracted with DDWA. This anticompetitive behavior harms patients, especially those who still pay DDWA the same premium and then receive care from a dental office not contracted with DDWA.
• We shared data that quantifies DDWA’s anticompetitive advantage over its competitors for a “routine” patient visit (periodic exam, radiographs, adult prophy). On average, the company pays between $147-$173 LESS than its competitors for this routine visit when a patient goes to a dentist outside the DDWA network. This table outlines our research and provides more details about the graph at the top of this message.
• We reported that our research has not uncovered another carrier in the United States that uses DDWA’s anticompetitive tactic. This DDWA practice is an outlier from the practices of Delta Dentals in other states and other carriers more broadly.
• We discussed how, in a normally functioning, competitive marketplace, insurance carriers’ networks are built, in large part, through negotiations on reimbursement rates for dental services. On the margin, increasing reimbursement rates tends to increase the number of dentists who will contract with a carrier, while decreasing reimbursement rates tends to reduce the number of dentists who will contract with that carrier (think of those supply and demand curves from any ECON 101 textbook).
• We pointed to recent actions by Premera Blue Cross as an example of behavior in a normal competitive market. Premera announced contracted reimbursement rate increases for October 2024 and May 2025 to many dentists that, combined, are increasing dentist reimbursement rates by approximately 24%. In a competitive market, Premera’s action would be expected to increase the size of its network of contracted dentists and perhaps prompt a response from its competitors.

We were encouraged by Commissioner-elect Kuderer's interest in, and receptivity to, the information we provided. As expected, DDWA stridently opposed our proposed reforms, and we expect DDWA will fight aggressively to preserve its anticompetitive advantage. We will need your help in the coming weeks to help communicate the importance of our dental benefits legislation to your legislators.

As you may have read in this article from the most recent issue of WSDA News, dental benefits reform is the centerpiece of WSDA's 2025 legislative agenda. We have drafted a bill that would stop DDWA from leveraging its anticompetitive advantage to the detriment of patients and dentists. We expect that bill to be introduced during the first week of the legislative session. 

Stay tuned for more information on our legislation and how you can help us move it forward in Olympia. You can expect to receive a series of updates, including specific calls to action (to sign up for text alerts, text the word WSDA to the number 52886), as the bill is considered. In the meantime, thank you for everything you do to enhance oral health in Washington.