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- State champs
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Affiliate legislative wins in 2025 aided by battle-tested legal and policy experts
February 24, 2026
Grassroots efforts are moving the needle for optometry.
Tag(s): Advocacy, State Advocacy
Key Takeaways
- The AOA State Government Relations Committee (SGRC) tracked more than 100 bills during the 2025 legislative session across the country and spurred advocacy teams to get involved at the state level.
- States are expanding optometry’s scope of care, reforming vision benefits managers (VBMs), and securing sell-and-dispense rights and telemedicine rights.
- These wins are the direct result of grassroots advocacy.
Last year was a busy one for the AOA State Government Relations Committee (SGRC) and state optometric associations nationwide. The SGRC tracked more than 100 bills during the 2025 legislative session across the country and spurred advocacy teams to get involved at the state level.
SGRC Chair John Whitlow, O.D., says he’s excited to see the surge in involvement from local optometrists. “Across the country, we are improving our grassroots,” he says, “and if we have those grassroots, these bills tend to get defeated.”
The results are encouraging: states are expanding optometry’s scope of care, reforming vision benefits managers (VBMs), and securing sell-and-dispense rights and telemedicine rights.
The most significant state wins
Arkansas, Nevada and Texas made significant VBM reforms.
- In Arkansas, H.B. 1353 became Act 142 in February 2025. The law created avenues for lab and supplier choice protections, anti-tiering and steering provisions, protections for noncovered provisions, Medicare-based reimbursement standards, and protections for audit and payment reform.
- Nevada’s H.B. 448 became law in May 2025, expanding the regulation of vision plan benefits, protecting lab choice and clinical decision making, non-covered services, and provider contracting and reimbursement.
- In June 2025, Texas created an Any Willing Provider (AWP) framework for vision plans. The framework requires fair access to participation for optometrists and adds stronger credentialing, transparency, and audit protections.
West Virginia, Montana and Minnesota celebrated scope expansion wins.
- West Virginia optometrists can now perform laser procedures, including yttrium aluminum garnet (YAG) lasers, selective laser trabeculoplasty (SLT), and laser peripheral iridotomy (LPI), as well as minor eyelid procedures. The law also establishes board certification requirements.
- Montana also gained approval for laser and surgical procedures, limited to the anterior segment of the eye. Approved procedures include injections, YAG, SLT, and LPI, as well as treatment of ‘lumps and bumps’. The law also gives the Montana Board of Optometry the right to establish training and certification standards for licensure as optometrists.
- Minnesota’s HF 2 removed restrictions on 7-day oral antiviral medications and 10-day oral carbonic anhydrase inhibitor restrictions. Optometrists now have the authority to administer local anesthesia and paralytic agents, and to remove lesions measuring 5 mm or smaller. They can now also prescribe oral steroids for up to 14 days.
Georgia optometrists gained the right to dispense and sell necessary medications for eye health and ocular adnexa. Dr. Whitlow testified before the Senate committee, describing the need for immediate access to certain medications and advocating for better patient care by expanding convenient access.
North Dakota earned a decisive win against scope limitations with the passage of H.B. 1267. The bill, signed into law in March 2025, establishes clear guidelines for optometric telemedicine services. The law amends the state’s scope of practice act to include greater authority for the North Dakota Board of Optometry. Patients in low-provider-density areas will now have easier access to care.
Fighting on two fronts
These wins are the direct result of grassroots advocacy, according to Dr. Whitlow. While all efforts are impactful, he says that many states are now realizing the differences in fighting scope limitation legislation and VBMs. VBMs tend to have more opaque language, requiring attention to detail. Scope, he says, is more clear-cut: fighting the medical community is ongoing and will not cease anytime soon.
That said, the tools are the same.
“Whether it’s at the state or federal level, grassroots advocacy and relationships are what move the needle,” Dr. Whitlow says. “We still have a large population that believes bills pass on merit. We wish that were true, but it’s the relationships that make the difference.”
Join your state optometric association or the SGRC to help continue the fight for optometry.