Dear Colleague:Regardless of how we may feel personally about the massive health care overhaul bill Congress approved and the President just signed into law, we can be very proud of the AOA's role in fighting and winning key battles to expand access to optometric care. Up against the insurance industry, organized medicine and other deep-pocketed special interests with an anti-optometry agenda - who if given the chance would have sought to erect new barriers between our patients and us - we have prevailed. Now we stand on the brink of a new era in our dealings with health plans.
The Harkin Amendment, a key element which we battled for at each step of the year-long legislative process, is the first-ever Federal standard of provider non-discrimination that will apply to all health plans, including self-insured ERISA plans. Even in 2010, many of these plans maintain an outdated view of us and the care we provide for our patients. Today, with the help of pro-access leaders in Congress like Sen. Tom Harkin, they will have no choice but to view us as we are: America's frontline providers of eye health and vision care.
Key AOA-backed elements of national health care reform legislation approved by Congress and signed in to law by President Obama on Mar. 23:
Establishment of the first ever Federal standard of provider non-discrimination which would apply to all health benefit plans, including self-insured ERISA plans. (AOA-backed Harkin Amendment)
No pre-emption of state insurance non-discrimination laws; creation of 50 (one in each state) state-based health insurance exchanges to provide coverage to the uninsured.
Designation of children's vision care as an essential health benefit.
No disruption of existing health coverage, including through vision plans.
Recognition of vision care in school-based health clinics.
New emphasis on the preferred "health care home" model of patient-centered care, which fully recognizes optometry, and a key rejection of the exclusionary "medical home" scheme.
Key AOA-backed provisions included in the "reconciliation" package approved by the U.S. House and now under consideration in the Senate:
Exemption for eyeglasses and contact lenses from a 2.9% medical device excise tax
Exemption of the cost of vision benefits from the calculation of a new excise tax on high-cost "cadillac" health plans
Key AOA-backed provisions that were considered over the last year, but not included in final health care overhaul bill:
☐ Full recognition of optometrists in Medicaid (House-passed Schakowsky Amendment based on HR 2697)
☐ Statutory inclusion of optometrists in Federal health programs, including the National Health Service Corps (Committee-passed Gordon Amendment based on HR 1884)
☐ Expansion of Federal eye health efforts targeting infants (Byrd Amendment). This provision is separate from the more than $1 million in Federal funding secured by the AOA in support of InfantSEE.
☐ Statutory non-pre-emption of state laws (House-passed Ross Amendment), viewed by AOA as an essential safeguard in the House-passed version of health care reform which sought to establish a single centrally-controlled interstate health insurance exchange, a proposal ultimately rejected by Congress and the Obama Administration. Instead, the final legislation will, in 2014, establish 50 state insurance exchanges to be administered by individual states and subject to state patient access / provider non-discrimination laws.
At a time of great change and uncertainty among all health care providers and those we serve, the inclusion of AOA priorities in health care reform will help our patients, our practices and our profession.
We still have much work to do – in Washington, DC, in state capitals, in the ophthalmic community, in the media and among employers and payers -- to gain the full recognition that we deserve and to pro-actively define our future.
On this occasion though, when confronted with an enormous challenge at the national level, optometrists across the country as well as state affiliate and AOA staff have together achieved an historic patient access victory that in the future could prove to be as significant as the AOA’s successful effort to achieve parity in Medicare 25 years ago.
Randolph E. Brooks, O.D.
For more information on the impact of health care reform or to find out how you can join the fight for patients and the profession, please contact the AOA Washington Office directly at ImpactWashingtonDC@aoa.org or visit our Health Care Reform website.
Make sure to also check out powerful video messages from AOA leadership on the passage of the health overhaul bill and what it means for AOA members, visit the AOA YouTube page at: http://www.youtube.com/aoaweb
Previous Legislative Achievements