Optometry gets results and more work to do in Washington, DC, tax bill battle 

As a controversial, multi-trillion-dollar budget reconciliation bill—H.R. 1, the One Big Beautiful Bill Act—advanced through Congress in recent weeks, AOA leaders and hundreds of doctor and student advocates worked tirelessly to ensure the voice of optometry was heard loud and clear in the nation’s capital at a crucial time. With this major legislative battle now over, it’s clear that optometry’s efforts have resulted in key successes, as well as new areas for vigilance and possible follow-up in the upcoming implementation phase.    

Signed into law on July 4, the nearly 1,000-page measure—which reflects the economic and federal spending priorities of the Trump administration and its allies in Congress—does include specific provisions actively supported by the AOA to help boost optometry practices as well as major changes to key federal health programs that will need to be closely monitored, including Medicare and Medicaid. Also, despite the lobbying efforts of anti-optometry interests, no portion of the legislation specifically singles out doctors of optometry or optometric care with harmful intent or any infringement in the profession’s essential and expanding role in health care.     

“This legislation emerged from a complicated policy and political landscape, and our efforts to be listened to and heeded were absolutely relentless and fully up to the task,” said William T. Reynolds, O.D., chair of the AOA’s Advocacy Group and past president, during the months-long battle on Capitol Hill. “No matter how any of us may feel about the bill or the process that produced it, every colleague can be proud that our AOA is and will continue to be a force for health and vision care in Washington, D.C., always fighting for our profession, our practices and our patients.” 

Advocacy leads to wins for optometry 

Thanks to persistent AOA doctor and student efforts, several key provisions were secured in the final package that directly benefit doctors of optometry. 

• A 2.5% physician pay increase for 2026 was included after intensive, last-minute advocacy by the AOA and other physician organizations. 
• AOA’s leading efforts reversed next year’s planned Medicare physician pay cut and laid the groundwork for longer-term reforms that would mandate annual positive pay updates. 
• AOA efforts also secured a full suite of tax benefits aimed at boosting small and mid-sized optometry practices, including:  
• Permanent extension of the 20% small business pass-through tax deduction originally set to expire in 2026; and 
• Successfully fought back a provision that would have barred optometry practices and others from deducting state and local taxes at the pass-through entity level, preserving a critical financial tool for many practices. 

Future impact on patient access under federal health programs, health research and education loans require continued close monitoring 

Along with immediate gains are areas that will require careful monitoring by the AOA and state associations starting right away. These include: 

• Medicare: The broken payment system still requires a permanent fix to avoid the threat of annual cuts to doctors of optometry and other physicians. The AOA will maintain a seat at the table as Congress considers next steps later this year.    
• Medicaid: New eligibility and funding requirements could impact the federal/state funding mix and ultimately physician reimbursement and coverage. The AOA and state affiliates will continue working to ensure that optometry and essential eye health and vision care are not targeted.   
• Veterans' Health Care: Anti-optometry groups continue seeking to roll back recognition and full practice authority for doctors of optometry. The AOA and the Association of Armed Forces and Federal Optometric Services will continue working to safeguard optometry’s full recognition throughout the Department of Veterans Affairs system, the nation’s largest health care network.      
• Federal Research Program Restructuring: Numerous proposals remain before Congress to overhaul federal agencies overseeing research funding, including optometry schools and optometry researchers. The AOA will continue to be the leading voice for optometry’s strong and growing research community, which plays a vital role in translating leading-edge research into innovative care and improved patient outcomes.   
• Education Loans: With fresh changes to the full range of federal student loan programs, including lifetime borrowing caps and updated repayment options, the AOA will continue to work for fairness for optometry students and optometry school applicants.   

Missing but not forgotten: health care middlemen reforms 

A significant setback for many health care stakeholders is what the bill doesn’t include: important health care middlemen reforms. Key Pharmacy Benefit Manager (PBM) reform measures—originally included in both House and Senate versions of the bill—were removed entirely from the final legislation. 

PBM reform is broadly supported on both sides of the political isle and both sides of the Capitol. Health care middlemen reform advocates are expected to continue pushing for inclusion of these reforms in Congress’ expected end-of-year package, opening an even larger window to advance Vision Benefit Manager (VBM) legislative reforms.  

Learn more 

As the 2025 tax law reshapes the financial landscape for health care providers and small businesses, there are actionable strategies and tips for optometry practices to consider, which the AOA has compiled for doctors.

DOWNLOAD FACT SHEET

Get involved: AOA on Capitol Hill 2025 

With the reconciliation bill now finalized and multiple priorities at the forefront, optometry’s advocates are 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 take part 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 how you can register to join hundreds of your colleagues in the advocacy fight.