AOA exposes and challenges VBM lobby group’s latest attacks on optometry

The AOA’s always-on presence in the U.S. Capitol complex is at the center of a winning effort this week to stand up for optometry and confront the latest attack on the profession, perpetrated by the National Association of Vision Care Plans (NAVCP). A lobby group, the NAVCP is opposed to legislation designed to crack down on abuses of the vision benefit middleman (VBM) industry, including the AOA-backed bipartisan Vision Lab Choice Act (S. 1716) and the Dental and Optometric Care Access (DOC Access) Act (HR 1521).  

The NAVCP identifies itself as “the unified voice for the managed vision care industry” and lists 15 giant companies as primary members on its website, including EyeMed, United Health Care, Versant and VSP. Deploying large teams of lobbyists and attorneys, the organization appears committed to trying to delay or block implementation entirely of newly enacted VBM accountability laws and regulations at the state level, even suing the state of Texas over the state’s sweeping law approved in 2023.  

According to materials prepared by the group and distributed in recent days on Capitol Hill and possibly more widely, NAVCP opposition to the Vision Lab Choice Act is centered on the view—offered without any valid proof of any kind—that doctors of optometry are intent on imposing “excessive mark-ups” of as much as 400% on their patients, outrageously raising a specter of extreme greed and indifference to the needs and interests of patients among optometric practices that have proven to be an essential and trusted access point for care. Also, and again without any support cited, the NAVCP wrongfully asserted that basic contract review provisions for doctors would prevent plans from assuring continuity of care, though they completely omit that health and vision plan tying arrangements are a significant and ongoing cause of the disrupted and fractured care model they’ve devised. 

“It is telling—but not surprising—that NAVCP and VBMs at large are opposing us as they are,” says AOA President Jacquie M. Bowen, O.D. “Their reliance on scare tactics and misinformation is designed to mask the truth: their business models depend on restricting doctor choice, suppressing competition and prioritizing profits over patients. No matter the other side’s vast resources or apparent eagerness to denigrate the integrity of our profession, our AOA will never allow the VBMs to have the last word on Capitol Hill, with the media or with the public.”  

AOA takes immediate action 

The AOA’s team on Capitol Hill responded immediately, fact-checking NAVCP false claims and detailing for concerned senators and their aides the array of abuses the VBM lobby refuses to acknowledge. Also, together with every affiliate, the AOA is locking in the hundreds of meetings all around the U.S. Capitol complex to be led by more than 600 advocacy-focused doctors and students who will be participating in the AOA on Capitol Hill mobilization later this month. 

The NAVCP’s tactics in Washington, D.C., follow earlier public attacks by the group that have targeted optometry and attempted to portray a significantly limited and diminished role for doctors of optometry in the health care system. In February, an NAVCP lobbyist voiced the group’s opposition to VBM accountability legislation before the Arkansas legislature (since enacted into law) with the claim to legislators and a streaming audience that “If I can be blunt, all optometrists are salespeople—that is how optometric practices make their money.”  

According to Steven T. Reed, O.D., AOA Advocacy chair and immediate past president, “It appears that NAVCP’s lobbying playbook comes down to one dangerous approach: misalign, manipulate and mislead.  Fortunately, the AOA is watching and, at all times, will continue standing up for optometry’s essential and expanding role in health care as well as the firmly established honor and dignity of our profession, our practices and our patients.”     

NAVCP’S sloppy work 

The AOA and other advocacy organizations that present on a regular basis to members of Congress or other government officials take great care with regard to the accuracy of statements and materials and recognize the urgent importance of ensuring that all information is substantiated and up to date. For more than a decade running, the AOA’s Capitol Hill team has been recognized through insider surveys for being especially trusted, reliable and respected sources for health policy information and data on Capitol Hill and across Washington, D.C.  

NAVCP takes a different approach.    

One doctor of optometry who was very surprised to learn of NAVCP’s lobbying claims this week is Neil Gailmard, O.D. A 2012 opinion article authored by Dr. Gailmard—which is no longer accessible online—was listed in the sole active footnote included in the NAVCP document and, shockingly, was referenced as the source for the outrageous upcharge smear.    

Dr. Gailmard was contacted by the AOA, and he expressed concern that research and comments focused on unrelated matters in 2012 were being misused and misconstrued in 2025.  

“My article clearly states that a 4X markup would be appropriate for frames with ‘a lower wholesale cost,’” Dr. Gailmard says. “Frames with a wholesale cost of $5 to $10 were used as examples in my article. A 4X markup on a $5 frame would make it sell to the patient for $20. The $15 profit to the optometrist is hardly excessive and it is compensation for the professional service aspect of dispensing eyeglasses.”  

Dr. Gailmard adds: “I fully support the Vision Lab Choice Act and the views of the American Optometric Association on that legislation.”  

AOA demands answers  

When confronted directly by the AOA, the VBM lobby group was forced into damage control. Under questioning, NAVCP acknowledged that its Capitol Hill lobbying materials and claims, as exposed and called out by the AOA, are inaccurate and must now be officially withdrawn from every Congressional office that has received them.    

At the same time, the group refused the chance to disavow its pattern of increasing and baseless public attacks on America’s doctors of optometry. While claiming to be open to a dialogue with optometry, the NAVCP offered no upfront commitment to change tactics or hostile rhetoric or even seek to adhere to a higher standard of conduct.    

 Also notable from the group: 

• On the issue of upcharging by vision plans and their related businesses, NAVCP declined to comment, citing a lack of an organizational policy that it could apply to its member companies.
• On the issue of plan-caused coverage and care disruptions, NAVCP asserted that it takes no position on any health plan-specific policies, a claim that raises fresh questions about the group’s credibility on major state issues, including any willing provider laws and network directories.  

Adds Dr. Reed, “The VBM industry and their lobbyists have a serious and growing credibility problem, and the increased scrutiny they’re now receiving is fully justified.  For this reason and more, the AOA and our affiliates must remain vigilant and unwavering in the work of fully protecting our patients and safeguarding optometry’s essential and expanding role in health care.”   

Bill aims to combat anti-competitive behaviors, lower costs 

Introduced in May by Sens. Kevin Cramer, R-N.D., Chris Murphy, D-Conn., and Markwayne Mullin, R-Okla., the Vision Lab Choice Act seeks to combat the potential for anti-competitive market behaviors, lower costs for patients and doctors, as well as preserve decision-making power within the doctor-patient relationship. The Senate bill complements a similarly bipartisan effort in the U.S. House, H.R. 1521, the Dental and Optometric Care Access (DOC Access) Act, to promote vision benefit manager reform.

S. 1716 would accomplish the following: 

• Prohibit plans from restricting or limiting doctors’ choice of optical laboratories and sources or suppliers of vision materials provided to patients. 

• Restrict plan-provider contracts for limited-scope vision benefits to two-year terms with allowance of an extension with agreement from the doctor. 

Roughly 200 million Americans have preventive eye exam and materials benefits administered by a VBM—the two most dominant of which cover as much as 85% of the market. Years of strategic, vertical integration by these conglomerates mean VBMs exact an oversized role in the market, controlling patient choice and squeezing independent optometry practices ever tighter. Such is the case, mounting fervor behind VBM reforms that curb costs and bolster the doctor-patient relationship have led to a coalition of advocates and demanded Congressional attention. 

“The Vision Lab Choice Act is a clear, commonsense solution to stop VBMs from interfering with the doctor–patient relationship and limiting patient choice,” Dr. Bowen says. “By prohibiting VBMs from forcing doctors into vertically integrated profit schemes and restricting access to the laboratories and suppliers that best serve patients, S. 1716 puts the focus back where it belongs—on delivering the highest quality eye health and vision care.” 

AOA on Capitol Hill 2025 focuses on VBM advocacy  

On Sept. 28-30, optometry’s advocates will participate in AOA on Capitol Hill 2025 in Washington, D.C. VBM reform ranks chief among the profession’s priorities to members of Congress.  

As the AOA’s single-largest annual advocacy event, AOA on Capitol Hill directly connects advocates and leaders with our nation’s policy leaders to advance optometric eye health and vision care for the benefit of all Americans. This annual hill day is a key reason why the AOA is consistently recognized as one of the most effective, respected advocacy organizations in the nation’s capital with hundreds of doctors, optometry students and affiliate leaders participating in this three-day fly-in event. 

“As more than 600 doctors of optometry and students head to AOA on Capitol Hill later this month, we are focused on ensuring that policymakers see through [VBMs’] self-serving narrative,” Dr. Bowen says, “and stand with us in advancing legislation that ensures fairness, transparency and health-first decision making.”