DOC Access Act reintroduced amid growing Capitol Hill vigor for VBM reform

AOA priority legislation that seeks to directly confront costly, controlling and care-limiting Vision Benefit Manager (VBM) abuses has been reintroduced in the U.S. House by powerful champions amid growing Capitol Hill activity aimed at forcefully addressing increasingly harmful VBM tactics. 

On Feb. 25, Reps. Earl L. “Buddy” Carter, R-Ga., and Yvette Clarke, D-N.Y., reintroduced the bipartisan Dental and Optometric Care Access (DOC Access) Act (H.R. 1521) in what the influential bipartisan pair asserts in a recent news release as an effort to “curb costs and put control of important health care decisions back into the hands of patients and their doctors.”  

While both lawmakers are longtime VBM reform champions, their powerful new posts signal growing Congressional prospects and urgency for VBM reform. Rep. Carter now chairs the powerful House Energy and Commerce Health Subcommittee and Rep. Yvette Clarke, also a leading member of Energy and Commerce, now chairs the Congressional Black Caucus.  

“It is important that we continue to work toward affordable, accessible and high-quality health care for all Americans. The DOC Access Act moves us in the right direction by ensuring dentists and optometrists can make decisions that are best for them and their patients, not the insurance company,” said Rep. Carter. 

"Every year, countless Americans are forced to confront inordinate roadblocks to the vision and eye care they need due to unnecessary restraints on their optometrists. People should always be empowered to make their own health care decisions, just as good doctors should always be available to carry them out. I’m proud to support this bipartisan legislation that puts power back in the hands of the patients, preserves their access to care, and creates a more equitable, more sustainable health care industry," said Rep. Clarke. 

The bill reintroduction comes amid record lawmaker attention and energy directed at exposing and reforming some of the worst VBM abuses. There are no less than three separate, ongoing and expanding investigations into harmful VBM schemes, including those targeting increased scrutiny from the Federal Trade Commission and the Department of Justice. Another was spurred by the now-chair of Energy and Commerce, Rep. Brett Guthrie. And a third effort is closely linked to ongoing Supreme Court review of the appropriateness of VBMs and others dodging state-level anti-plan-abuses laws. 

A growing coalition of support  

The legislation also is being introduced in response to growing patient and consumer advocacy for VBM reform. Leading consumer advocates, including the National Consumers League, led a Capitol Hill briefing exposing their frustration with VBM abuses and issuing a call for immediate action. Patients Rising, a leading national patient advocacy organization, has activated their national patient network, produced an animated video pulling the curtain back on and alerting the public to increasingly harmful VBM schemes, and is increasingly calling on Congress to act.  

"Patients Rising is so thankful that Reps. Carter and Clarke are leading the charge on such an important issue to patients across the country," said Terry Wilcox, CEO and chief mission officer for Patients Rising. "Like we see with pharmacy benefit managers, dental and vision benefit managers are out of control—and patients are literally paying the price. With only a handful of insurers dominating the market, their middlemen are hard at work setting prices and rigging a system that benefits only them at the expense of patients and our communities. The last place your insurer should be is in the exam room with you and your doctor. That's why we're thankful for this effort and we're committed to continue working hard to expose and put an end to the costly, controlling, and care-limiting schemes of insurers and their benefit managers.” 

“The AOA, doctors of optometry and patients across the country applaud the introduction of the bipartisan DOC Access Act, introduced by Reps. Carter, Clarke and supported by hundreds of visionary House and Senate health policy leaders,” says Steven T. Reed, O.D., AOA president. "This legislation provides a clear, patient-focused solution to put a stop to abusive practices by Vision Benefit Managers (VBMs), including price fixing for items and services not covered by the plan and steering patients and doctors to VBM-owned labs, which too often results in higher costs, inferior products and unacceptable wait times. From statehouses across the country to the U.S. Capitol, legislators are taking commonsense action to address the increasingly harmful effects of growing VBM market concentration and vertical integration, and this bill is a pivotal step in continuing that momentum.” 

A committed opposition 

The bipartisan effort in Washington, D.C., and in state capitals to crack down on VBMs has drawn the active opposition of the National Association of Vision Care Plans, a lobbying group representing Eyemed, VSP, United Healthcare Vision, Versant, Aetna/CVS, National Vision and other companies. Public disclosure filings, news accounts of legal challenges and other reports on the influence activities of the NAVCP and its member companies point to lobbying and legal costs running into the tens of millions of dollars and involvement of nationwide networks of lobbyists and attorneys.  

William T. Reynolds, O.D., AOA trustee and advocacy chair, observes, “In spite of the NAVCP’s vast resources, our AOA and our affiliates are outworking our opponents and we are winning new supporters in Congress, state legislatures and the media. Also, thanks to our coordinated advocacy that’s focused squarely on policy change and VBM accountability under the law, as well as our strong alliances with Patients Rising, the National Consumer League, the American Dental Association and more than a dozen other important organizations, optometry is doing more than ever to set the agenda and force the other side to defend outrageous tactics. We must and will keep at it.”   

Support optometry’s advocates 

The AOA and its partners will be working overtime this year to ensure that Congress steps up to stop vision plan abuses—and you can be part of this action: 

Visit AOA’s Action Center to urge your House and Senate members to co-sponsor H.R. 1521 or text “DOC” to 1.855.465.5124. 

Make plans to attend AOA on Capitol Hill in Washington, D.C., and join thousands of other advocates fighting for patients and the profession. The AOA's single-largest annual advocacy event is moving to an all-new date in 2025, September 28-30. Registration will open soon; stay tuned for updates from the AOA.