Optometry wins key health plan battle

Optometry Wins Key Health Plan Battle in Washington


The months-long lobbying effort by optometry to hold the line on state-enacted patient protections for eye and vision care services and to establish a new marker at the Federal level for health provider non-discrimination protection has been successful. In a key vote taken on May 11th, the U.S., Senate rejected the Health Insurance Marketplace Modernization and Affordability Act (S. 1955), legislation designed to establish small business health plans exempt from many state coverage requirements and placed on the legislative fast-track earlier this year. The Senate Republican leaders backing the bill fell 5 votes short of the 60 required to move forward with consideration.

The AOA raised concerns about the S. 1955 at each step of the legislative process. Although earlier versions of the bill would have allowed health plans to discriminate against ODs, through an aggressive Keyperson, grassroots and direct lobbying response, optometry was heard loud and clear in the U.S. Capitol and succeeded in ensuring that this issue was addressed both by the bill's prime sponsors -- Senator Mike Enzi (R-WY) and Senator Ben Nelson (D-NE) -- and other pro-optometry leaders in the Senate like Susan Collins (R-ME) and Lisa Murkowski (R-AK). In particular, the AOA-backed Collins-Murkowski amendment to S. 1955, strongly opposed by organized medicine, will help set a new standard for future debate in Congress over provider discrimination by insurers, a top priority for optometry over the last year. Click here for a recap of optometry's efforts and an overview of S. 1955.

Optometry's effective response to S. 1955 was led by the AOA Board of Trustees; AOA Executive Director Dr. Mike Jones; the leadership and staff of AOA affiliates; AOA Congressional Keypersons; the volunteers in the AOA Advocacy Group (Federal Relations Committee, AOA-PAC, State Government Relations Center, AOA Eye Care Benefits Center and Federal Legislative Committee); AOA Office of Counsel; and the AOA Washington Office. The AOA secured and kept a prized seat at the table with Senate leaders from both parties and was a driving force in the effort to ensure that, if the bill was to be approved, it would contain the safeguards necessary to fully protect ODs and patients from access and fee discrimination by health plans.

Just prior to the roll call last night, Senator Enzi, the Chairman of the Senate Health Committee, and Senator Nelson recognized the positive and effective role the AOA played in this debate, and the results that were achieved by our efforts to highlight the discrimination that ODs are facing in Medicare managed care plans. Should there be further attempts in the Senate this year to consider small business health plan legislation, whether based on S. 1955 or the more far-reaching bill developed in the U.S. House, the AOA will be well positioned to continue to raise the priority concerns of optometry.