States enact 21 dental insurance reform laws in 2026 legislative sessions: 8 notes

State lawmakers have continued advancing dental insurance reforms in 2026, with 14 states enacting 21 laws so far this year, the American Dental Association reported July 16.

Eight notes:

1. More than 100 dental insurance reform bills were introduced in 37 states during the 2026 legislative session, building on more than 30 laws that were enacted across 18 states in 2025. Issues addressed in the legislation include dental loss ratios, virtual credit card payments, network leasing, assignment of benefits, retroactive claim denials and downcoding.
2. Mississippi enacted a dental loss ratio reporting law requiring insurers to disclose the percentage of premium dollars spent on patient care. 
3. Wisconsin, Louisiana and Georgia strengthened virtual credit card protections, with Georgia and Louisiana replacing opt-out systems with opt-in requirements that require insurers to obtain a dentist’s express consent before issuing payment through a method that carries transaction fees. Wisconsin enacted legislation that limits insurers’ exclusive use of virtual credit cards.
4. Seven states introduced legislation addressing network leasing, with Colorado and Wisconsin both enacting network leasing protections. Colorado’s law requires insurers to obtain a dentist’s permission before including that dentist in a leased network and prohibits penalties for dentists who decline to participate. Wisconsin’s law allows dentists to exit a leased network without terminating their original provider contract.
5. Oregon and Maryland enacted assignment of benefits laws, bringing the total number of states with such laws to 30. The new laws require insurers to pay dentists directly when patients request assignment of benefits, regardless of network participation.
6. Connecticut, Indiana and Oregon narrowed the window during which insurers may seek repayment of previously paid claims. 
7. Indiana also enacted new downcoding standards that prohibit insurers from relying solely on automated systems when reducing reimbursement, instead requiring human review and written justification.
8. Despite state-level momentum, many reforms do not apply to patients covered by self-funded employer plans due to how insurers interpret ERISA, the ADA noted in its new release. The ADA is advocating for the Improving Dental Administration Act, which would close the ERISA loophole and require payers to follow state dental insurance laws more broadly.

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