Get the inside scoop on the issues at play for AOA on Capitol Hill

One legislative battle down already in 2025, optometry’s advocates gear up for another as hundreds of AOA doctors and students look to ensure optometric eye health and vision care remains at the forefront of policymakers’ minds in Washington, D.C. On the heels of a controversial, multi-trillion-dollar budget reconciliation bill advanced through Congress this summer, containing key Medicare pay and tax provisions for optometry, AOA on Capitol Hill is poised to put advocates back in the nation’s capital to advance work still yet to be done. 

🗎 ACCESS: What Doctors of Optometry Need to Know About the 2025 Tax Law 

A foundation of the AOA’s federal advocacy efforts and the single-largest annual advocacy gathering, AOA on Capitol Hill, Sept. 28-30, in Washington, D.C., connects our profession’s leaders to the nation’s policy leaders to advocate and support optometric eye health and vision care. This connection is what keeps the AOA recognized as one of the most effective, respected advocacy organizations in Washington. Because when policymakers are making decisions, they rely on the expertise and experience of professionals like you. 

Dr. Alexander adds: "Doctors of optometry and optometry students from across the country will attend AOA on Capitol Hill to personally advocate for Americans' eye health and vision care needs, sending an immensely powerful message to our nation's leaders."

So, what are the priority issues that need to be addressed at AOA on Capitol Hill? Review the list below to see how your AOA and affiliates are advocating in Washington, D.C., for optometry. 

Issue 1: Addressing anti-doctor, anti-patient VBM abuses 

While health care middlemen reforms enjoy broad, bipartisan support in Congress, key pharmacy benefit manager (PBM) reforms ultimately didn’t make the cut for H.R. 1, the One Big Beautiful Bill Act. That makes Congress’ next hurdle, an end-of-year government funding package, even more consequential for PBM reforms—and by extension, an opening to advance vision benefit manager (VBM) reforms during AOA on Capitol Hill. 

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. But years of strategic, vertical integration by these conglomerates mean VBMs can exact an oversized role in the market, controlling patient choice and squeezing independent optometry practices ever tighter. Plans’ stagnant pay scales and anticompetitive policies have placed optometrists in a bind as they grapple with the increased costs and challenges of delivering care. 

However, the AOA and affiliates continue to push for VBM reforms that curb costs and bolster the doctor-patient relationship, all the while building a coalition of advocates that demand Congress’ attention. 

📺 WATCH: Patients Rising video on stopping VBM abuses.  

Bolstering state efforts to pass VBM reforms, the AOA is championing VBM reforms through: 

• Federal legislation. The AOA supports both H.R. 1521, the Dental and Optometric Care (DOC) Access Act, as well as S. 1716, the Vision Lab Choice Act. Both bills look to outlaw VBM’s controlling, care-limiting policies. 
• Federal investigations. No fewer than three Congressional investigations into VBMs, their policies and market actions have been launched by the U.S. House Oversight Committee, House Energy & Commerce Committee and U.S. Senate Appropriations Committee. 
• Direct plan advocacy. Doctors can email stopplanabuses@aoa.org with a health or vision plan challenge and the AOA will help fight on their behalf. This direct advocacy has already had an effect, driving over $7.5 million back into optometry practices. Additionally, the AOA offers resources to empower doctors in these issues, including responding to automatic downcoding programs. 

 Access the 2025 AOA VBM Abuses Fact Sheet to see the latest information on these efforts. 

Issue 2: Fixing the contact lens prescription verification system 

Preserving the doctor-patient relationship needs to be the foremost priority when it comes to the contact lens marketplace as loopholes in the current prescription verification process allow retailers to skirt patient safety requirements.  

Popular with over 45 million Americans, contact lenses are a safe and effective vision-correction option when worn and cared for properly. However, poor-fitting or improperly used contact lenses can result in serious eye and vision harm, which is why the U.S. Food and Drug Administration (FDA) regulates contact lenses as Class II and III medical devices that require an eye doctor’s prescription and oversight. Both the FDA and Centers for Disease Control and Prevention advise consumers that contact lenses are not “one size fits all” and that regular comprehensive eye examinations are necessary for ensuring optimal eye health. 

Despite these health and safety concerns, some online contact lens retailers not only permit consumers to purchase these medical devices using expired prescriptions but also sell altogether different brands or types of contact lenses than were prescribed by the patient’s doctor. Although outlawed by the Fairness to Contact Lens Consumers Act (FCLCA) and Contact Lens Rule, retailers commonly take advantage of the law’s interpretation to subvert its intent. 

The AOA, in partnership with the Health Care Alliance for Patient Safety (HCAPS), is advocating for the doctor-patient relationship, including through legislation to make the prescription verification process simpler and safer. 

Introduced by Rep. Morgan Griffith, R-Virginia, H.R. 4282, the Contact Lens Prescription Verification Modernization Act, would: 

• Require retailers to use direct communication to confirm prescription accuracy. 
• Require retailers to offer a HIPAA-compliant method for allowing patients to upload a copy of their prescription directly. 

The AOA Health Policy Institute has reported that as many as 89% of optometrists providing contact lens services have received verification calls for invalid prescriptions and more than half have received calls for an altogether wrong patient. 

The AOA and Health Care Alliance for Patient Safety continue to speak out against patient safety problems precipitated by direct-to-consumer internet mass retailers, already resulting in major federal action. 

Issue 3: Seeking long-term Medicare pay and fairness 

Consequentially, H.R. 1 did secure a 2.5% pay increase in 2026 for Medicare physicians after an intensive, last-minute advocacy push by the AOA and other physician organizations. This allayed what was poised to be yet another statutory reduction in Medicare physician pay; however, Medicare’s broken payment system still requires a permanent fix to avoid the threat of annual cuts. 

The AOA and other physician organizations continue to advocate for a permanent fix tied to an annual positive pay update, a proposal that may be considered in Congress' year-end funding legislation and at play during AOA on Capitol Hill. 

Additionally, optometry’s advocates will look to apprise members of Congress about the ongoing challenges with Medicare Advantage plans, ensuring plans are held accountable for improved patient benefits and care, as well as ending discrimination against doctors of optometry when it comes to plan participation. 

Issue 4: Stopping organized medicine’s turf-obsessed VA policy agenda 

On Jan. 2, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act was signed into law, effectively adding optometry to the physician pay scale and giving the Department of Veterans Affairs (VA) the latitude to offer increased pay awards, bonuses and annual evaluations. This significant achievement by the AOA and Association of Armed Forces and Federal Optometric Services (AFOS) effectively provides physician-level recognition for doctors of optometry, while also helping better meet veteran demand for eye care by closing a doctor recruitment and retention gap. 

Physician-level recognition for VA optometrists was a key priority championed by doctors and students during AOA on Capitol Hill 2024—and its resolution is a testament to the efforts of optometry’s advocates. But again, advocates will be fighting for optometry’s abilities. 

For years, the AOA and AFOS have fought for optometry’s full recognition in the VA’s national standards of practice and their ability to provide full-scope optometric care. While the VA partially removed its ban on optometric laser procedures, as well as reversing its decision to prevent community care doctors from providing legally authorized scope procedures to veterans, optometry’s opponents have attempted to roll back these scope advancements at the sacrifice of veterans’ access and care. 

Optometry’s advocates will continue to champion optometry’s full recognition during AOA on Capitol Hill this fall. 

How you can join optometry’s advocates at AOA on Capitol Hill 

Open to all advocacy-minded AOA doctors and optometry students, AOA on Capitol Hill, Sept. 28-30, in Washington, D.C., expects to see hundreds of optometry’s advocates championing these issues and more with members of Congress.  

What: AOA on Capitol Hill 
When: Sept 28-30 
Where: Grand Hyatt Washington 

Are you an optometry student? AOSA members are eligible for complimentary registration, housing and travel assistance to this year’s AOA on Capitol Hill—find out more here.