U.S. senators introduce VBM reform bill amid growing plan scrutiny

U.S. senators introduced a new bill to outlaw vision benefit managers’ (VBMs) controlling, care-limiting policies at the height of federal scrutiny of plans—as optometry’s advocates prepare to champion reforms on Capitol Hill. 

Introduced by Sens. Kevin Cramer, R-N.D., Chris Murphy, D-Conn., and Markwayne Mullin, R-Okla., the Vision Lab Choice Act of 2025, S. 1716, 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 AOA-backed 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 VBM reform. 

Specifically, 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. 

Growing support for VBM reform 

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.

S. 1716 is jointly backed by the AOA, as well as leading patient and consumer advocate groups, Patients Rising and the National Consumers League. These advocates have championed VBM reforms at a federal level for years, culminating with a Capitol Hill briefing in September 2024 at the request of the House Oversight and Accountability Committee.

What’s more, the latest Senate bill reinforces legislative efforts in the House with H.R. 1521, the DOC Access Act. Reintroduced in February by Reps. Earl “Buddy” Carter, R-Ga., and Yvette Clarke, D-N.Y., the DOC Access Act would also prohibit plans’ restrictions on lab or supplier choice and introduce contracting limits.  

📨 Use the AOA Action Center to encourage support for the DOC Access Act. 

Critically, both legislative efforts in this Congress come amid record lawmaker attention and energy directed at exposing and reforming abusive VBM policies, including launching multiple investigations: 

• A Government Accountability Office investigation into VBM consolidation, market concentration and the impact on patients. 
  

• A House Committee on Oversight and Accountability directive for the Department of Justice to evaluate the effects of market concentration among VBMs and their vertical integration, as well as a request for information from the Federal Trade Commission on the agency’s role in preventing unfair and harmful practices in the vision marketplace.

• Senate Committee on Appropriations language calling for a federal probe of VBM abuses and the growing trend of VBMs sidestepping state vision plan laws by inappropriately claiming federal preemption. 

This last investigation represents an open legal question currently before the U.S. Supreme Court. The nation’s highest court is actively reviewing a related question about pharmacy benefit managers (PBMs) claiming ERISA preemption from state regulation. In June 2024, the AOA joined the American Dental Association and other health care organizations in an amicus brief supporting the need for plans to comply with consumer protections. Additionally, no less than 31 states and Washington, D.C., backed review of this legal question. 

AOA on Capitol Hill 2025 focuses on VBM advocacy 

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

What: AOA on Capitol Hill 2025 
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 near future.