ACA replacement efforts falter, AOA remains vigilant

Congressional attempts to retool the American health care system met another roadblock in the U.S. Senate, but the AOA continues to be at the forefront of the debate, undeterred in advocating for optometry's priorities.

"With so much up in the air on the direction of health care reform, now and into the near future, we need the active involvement of every doctor of optometry."

Earlier this week, the upper house's version of an Affordable Care Act (ACA) repeal and replacement bill, known as the Better Care Reconciliation Act (BCRA), failed to gain enough consensus for a full vote on the Senate floor. Although that setback effectively ends the bill's current form, Senate leaders continue exploring their options, including holding a straight repeal vote, and voting on the U.S. House of Representatives' version, the American Health Care Act of 2017 (AHCA), later this session.

That former bill also met adversity, yet AOA remained steadfast in preserving optometry's priorities and addressing patient safety concerns throughout its debate, ultimately ensuring such provisions, as well as optometry's vital role and contribution to the health care system, were fully recognized.

That same level of vigilance is true in the current Senate debate, as AOA's scrutiny immediately identified concerning language in the BCRA that might preempt states' provider access and consumer protection laws.

In a July 17 letter to Senate Leadership, AOA President Christopher J. Quinn, O.D., called attention to a BCRA section that would have allowed federally-regulated, small-business health plans to sell products across state lines and avoid vital state-based access laws, specifically any willing provider laws, currently statute in 27 states. The AOA countered with proposed language that would expressly maintain current and future state provider nondiscrimination, payment and coverage parity, equal access, any willing provider and similar laws.

Additionally, the AOA appealed for inclusion of other provisions that outlaw anti-competitive abuses by health plans, safeguard patient choice, and strengthen the doctor-patient relationship, as well as note support for the Competitive Health Insurance Reform Act, H.R. 372. That bill would authorize the Federal Trade Commission and Department of Justice to enforce federal antitrust laws against health insurance companies engaged in anticompetitive conduct.

The AOA already champions bipartisan legislation, the Dental and Optometric Care Access Act (H.R. 1606), that would end anticompetitive, anti-patient abuses in the vision and dental coverage market, including harmful noncovered service requirements, unfair contractual linkage between vision and health plans, and elimination of doctors' lab choices. Also backed by the American Dental Association, the DOC Access Act would provide a crackdown on plans regulated at the federal level without pre-empting any of 40 similar state laws on the books.

"No matter what happens with health care reform in Washington, D.C., the AOA will continue to pursue our priorities, advocating to safeguard doctors' of optometry full physician recognition and inclusion in physician-level programs, and upholding existing laws that assure access to in-person comprehensive eye examinations, while ceasing abusive, anti-doctor health and vision plan policies, as reflected by provisions of H.R. 1606," Dr. Quinn says.

Health reform debate continues

The AOA remains committed to working with Congressional leaders and the administration to find a health care solution that works for all Americans, while at the same time defending optometry's hard-fought legislative and regulatory advances that underscore the critical care that doctors of optometry provide.

This renewed health reform debate is far from over and will likely take many forms before reaching its conclusion. Currently, there are several efforts to draft alternative language, and even reach across party lines, to find fixes for ACA's shortcomings, while alternatively, there is momentum to altogether end federal support in favor of rebuilding in its wake. Despite this uncertainty, AOA has a clear, unobstructed focus on keeping doctors of optometry and their patients first and foremost in this debate.

"The AOA continues to work 24/7, 365 days a year, on behalf of our patients and the profession," Dr. Quinn says. "With so much up in the air on the direction of health care reform, now and into the near future, we need the active involvement of every doctor of optometry—in AOA-PAC, in our grassroots efforts and fighting alongside us in the halls of Congress."

Crucially, it's important now more than ever to advocate for the profession and contribute to the discussion. Doctors of optometry can make a significant difference in this process by supporting AOA-PAC and helping keep the fight going. Also consider visiting AOA's Online Legislative Action Center to view the profession's current advocacy issues and encourage legislators to take action.

If you would like to learn more about how you can get more involved in federal advocacy, please contact AOA advocacy at advocacy@aoa.org.