AOA priorities advance as U.S. House approves sweeping legislation

AOA doctor and student advocates voiced optometry’s priorities with U.S. House and Senate leaders as Congress assembles a sweeping legislative package, seen by the AOA as both an opportunity to advance pro-optometry policies and a potential threat to reimbursement and coverage of optometry-provided care. 

On Thursday, the U.S. House narrowly passed the roughly 1,000-page, “big, beautiful bill” now making its way through Congress under a legislative maneuver known as budget reconciliation, which allows for passage under a rare simple majority vote in the Senate. The sweeping legislation contains equal parts opportunity and concern for optometry as the effort aims to cut federal spending and make key tax, health care, and other policy changes.  

Early recognition of both opportunities and threats led hundreds of AOA doctor and student advocates, many of them frontline advocates organized under the AOA’s powerful Federal Keyperson program, to spend months pushing their lawmakers to address the AOA’s top federal priorities in the legislation. It’s now clear with the House’s bill that the more than 5,000 doctor and student advocates’ outreach resonated. It’s equally clear that with the bill up for consideration by the Senate, there’s still much more advocacy work to do. 

Securing annual Medicare pay increases for optometrists and other physicians 

The AOA and other physician organizations have urged Congress to end cuts to Medicare reimbursements, including the ongoing 2.8% pay cut affecting doctors of optometry and other physicians. This year marks the fifth straight year of Medicare pay cuts, coming at the end of a two-decade decline in purchasing power that threatens optometry practices. 

H.R. 879, the Medicare Patient Access and Practice Stabilization Act, is an AOA-backed bill that would add an additional 6.62% to the Medicare Physician Fee Schedule Conversion Factor through Dec. 31, 2025, to eliminate the entirety of the existing reduction and provide a pay boost for the rest of the year. 

While lawmakers did not include H.R. 879 wholesale, the legislation approved by the House does include a historic linkage of future Medicare pay to doctors of optometry and others to the Medicare Economic Index (MEI), an inflationary index that reflects the rising cost of providing care to patients. That move aims to provide annual pay increases to doctors of optometry and other physicians, rather than the annual cuts the AOA has worked to stop.  

Increasing and making permanent AOA’s 2017 tax law win 

In 2017, the AOA fought for and won a provision that ensures doctors of optometry would benefit from a 20% tax deduction for small-business optometry practices organized as pass-through businesses, amounting to roughly $6,000 in tax savings to the average practice. While the provision is set to expire at the end of 2025, optometry’s advocates have pushed to renew the deduction, raise the deduction level, and make the cut permanent.  

The legislation includes a provision the AOA advocated for and strongly backs that would make the pass-through deduction permanent and would increase the deduction from 20% to 23%.  

Putting a stop to abusive tactics of benefit manager middlemen 

The AOA and other advocacy organizations continue to push lawmakers to address the abusive tactics of benefit manager middlemen. 

The legislation includes key provisions under consideration for more than a decade aimed at reining-in harmful policies of pharmacy benefit managers (PBMs) now operating within both the Medicare and Medicaid programs. 

While these changes would aid doctors and patients by helping to boost access to and lower costs for needed treatment, the move also clears a larger pathway for further Congressional action on vision benefit manager (VBM) abuses. 

The AOA, the American Dental Association, and more than a dozen patient and consumer advocacy groups, including Patients Rising and the National Consumers League, are increasingly pushing Congress, like they are doing now with PBM reform, to put an end to the costly, controlling and care-limiting policies of VBMs by passing H.R. 1521, the Dental and Optometric Care (DOC) Access Act.  

Protecting coverage of and payment for optometrist-provided Medicaid eye and vision care  

With Medicaid being one of the main targets for federal spending reduction under the reconciliation effort, AOA advocates recognized right away the serious threats to coverage of and state payment for optometrist-provided eye and vision care. AOA doctors and students continued to make clear to lawmakers that any cuts must not come at the expense of optometrist payments or patient coverage for that care. 

After extended advocacy, lawmakers dropped early plans for across-the-board cuts to federal Medicaid dollars sent to states, in favor of more targeted cuts. Although, with estimates that some 13 million may lose some or all of their Medicaid coverage, doctors and student advocates will continue working to ensure their senators understand that any cuts to optometrist payment or coverage for that care would be shortsighted and ultimately cost more in the long run.  

Get involved in the AOA’s federal advocacy 

With the reconciliation bill now moving to the Senate, stay tuned for further AOA advocacy alerts urging direct outreach to the Senate in the coming weeks.  

Optometry’s advocates are also invited to participate in AOA on Capitol Hill 2025, Sept. 28-30, in Washington, D.C. 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 all Americans. 

Hundreds of doctors, optometry students and affiliate leaders will participate in this three-day fly-in event—and you can, too. Save the date for this year’s event. 

What: AOA on Capitol Hill 
When: Sept. 28-30 
Where: Grand Hyatt Washington, D.C. 

Learn more about AOA on Capitol Hill and look for registration to become available in the coming weeks.