Alabama dentists say they are taking on a “system that prioritizes profits over people,” as they launch a campaign to help improve access to care in the state.

The Alabama Dental Association, which represents 1,600 dentists, announced the More For Your Smile campaign last week to require insurance companies to spend at least 85% patient premiums on their care, not on things like executive salaries or administrative costs.

“We’re committed to changing the way dental coverage works in Alabama by putting patients and their care first,” Michele Huebner, the executive director of the Alabama Dental Association, said in a press release. “For too long, patients and dentists have been caught in a system that prioritizes profits over people, and this legislative campaign aims to change that.”

The proposal would also provide for higher reimbursement rates for dentists, meaning they would get paid more when treating a patient who has insurance.

In Alabama, dental insurance companies aren’t required to spend a specific amount of a patient’s premium on their care, and they also aren’t required to share how much of your money goes to treatments.

The state dental association wants lawmakers to pass legislation that would also require insurance companies to disclose how they’re spending the money they collect from patient premiums.

Eight states, including Louisiana and Virginia, have similar laws in place, while dental organizations in about a dozen other states are campaigning for reforms.

“This is about creating transparency, accountability and fairness so patients get the care that they deserve,” said Huebner.

Alabama has the nation’s second-lowest ratio of dentists per population, according to the American Dental Association at just 41.6 dentists per 100,000 residents. Alabama narrowly topped Arkansas — a state without a dental school — which had 41.2 dentists for every 100,000 people.

In rural Alabama, there are nearly 3,845 patients for each dentist, according to an August report by the Alabama Department of Public Health. The public health agency warned that “many Alabama counties [are] at risk of losing vital dental services in the near future.”

Earlier this year, dentists told AL.com that the biggest barrier they face to keeping their practices open or opening new ones is low reimbursement rates.

“When you look at the number of patients I have, I’m doing great. We get north of 100 new patients a month,” Carson Cruise, a pediatric dentist in Florence, said in October. “But if you look at the amount of money the business collects, expenses have gone up so much that what goes in my pocket is about 10% less than what it was three years ago.”

Hannah Dailey, a dental student at University of Alabama, said she and her classmates want to stay in Alabama once they graduate, but low insurance rates make it difficult. Some of her classmates have already decided to take jobs in Georgia.

“A new graduate could move less than two hours away and make double simply because the reimbursement rates are so much higher. It’s not a question of if we want to stay here, but rather, if we can. Another classmate told me they’d love to stay in Alabama, but the uncertainty around the insurance policies here makes them feel like they’re taking a financial risk,” she said, noting the $300,000 debt she took on for dental school.

“Less than half of the students who graduated last year applied for licensure in the state of Alabama,” she added, “and many in my class are also headed to surrounding states as well.”

Dentists say there is a growing workforce issue in the state that could be improved by passing legislation to reform insurance coverage.

“I’ve had two hygienists that have left for adjacent states, one went to Georgia and one went to Tennessee, and she cried before she left,” said Leigh Kent, a dentist in Homewood, during a press conference. “She didn’t want to leave, but she just simply couldn’t afford to accept the rates that are being paid in Alabama versus other states.”

Kent, who serves as chair of the campaign, said increased reimbursement rates for dentists will improve access to care in Alabama.

Dentists say in the coming months they will begin talking to their patients about the campaign so they can participate “through conversations, grassroots efforts, and an online tool designed to educate and connect them with lawmakers.”

More information about the campaign can be found here.