The number of dental insurance reform laws across the United States has increased to 400, with 33 new ones added in 2026.

Source: ADA - "Shifting the Balance of Power"

DentalGoodNews｜On September 22, 2026 local time, the American Dental Association (ADA) announced that the number of Dental Insurance Reform (DIR) laws across the United States has reached 400. Since the ADA launched its tripartite advocacy in 2018, states have successfully enacted 238 new regulations aimed at reshaping the balance of power among insurance companies, dentists, and patients.

According to the ADA's latest "Shifting the Balance of Power" report, during the 2026 legislative session, 37 states across the country submitted more than 100 dental insurance reform proposals. As of now, 18 states have enacted 33 new laws. This round of reform focuses on long-standing operational pain points for dental practices, including network leasing, virtual credit cards, assignment of benefits, and retroactive claim denials (with 66% of states having implemented related restrictions).

Regarding Network Leasing, the reform requires insurance companies to obtain explicit knowledge and consent from dentists before including them in different networks. Previously, insurance companies often "leased" dentists to third-party networks without their consent, undermining dentists' operational autonomy. Currently, related regulations have taken effect in 68% of states.

The mandatory use of Virtual Credit Cards as a payment method is also one of the core issues of the reform, with the number of states covered by related laws increasing from 5 in 2018 to 39 in 2026. New laws stipulate that dentists have the right to choose their own reimbursement method, preventing insurance companies from imposing additional fees through specific electronic payment channels, thereby reducing clinic operating costs. Additionally, adjustments to Assignment of Benefits policies allow patients to directly request that insurance companies pay dentists, simplifying the settlement process, and has now taken effect in 60% of states.

Source: ADA - "Shifting the Balance of Power"

Beyond administrative optimization, the reform also involves Medical Loss Ratio requirements, mandating that insurance companies allocate the majority of premiums directly to patient care rather than administrative expenses or profits. Meanwhile, Noncovered Services restrictions prohibit insurance companies from manipulating prices for treatments not covered under policies, ensuring dentists receive reasonable compensation. This restriction has now taken effect in 88% of states, making it the issue with the highest coverage rate among the four categories of reform.

Dr. Richard Rosato, President of the ADA, pointed out that reaching 400 laws is the result of joint efforts by dentists, patients, and advocates, with each law representing a step toward transparency, fairness, and accountability. He emphasized that these achievements demonstrate the critical role of organized dental professional organizations in addressing the daily operational challenges faced by doctors.