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Medical groups tally defeats as AOA and affiliates stay alert to nationwide ‘not-a-doctor’ threat
February 25, 2026
AOA, affiliates continue to fight against restrictive legislation.
Tag(s): Advocacy, State Advocacy
Key Takeaways
- Although many ‘not-a-doctor’ bills have died in committee or failed to pass both chambers, constant vigilance and ongoing relationship-building are necessary to combat future attacks.
- To prevent damaging bills from gaining strength after leaving committees, the AOA State Government Relations Committee says the most effective defense is grassroots activism.
Optometrists are doctors, as evidenced by their education and degree, as well as long-standing federal recognition by the Social Security Act and Medicare law. Additionally, the U.S. Department of Veterans Affairs (VA) published new regulations last year implementing physician-level recognition for VA doctors of optometry.
Yet, on a state level, medicine-supported legislation continues to challenge that fact.
Across the nation, a growing number of state optometric associations have scored victories over medicine’s efforts to halt scope expansion or limit recognition of doctors of optometry. Nonetheless, currently Missouri and Washington are considering bills that would stop the natural progression of optometry’s needed expansion.
Looming threats to scope expansion
In Missouri, H.B. 2999 and S.B. 1254, supported by the Missouri Association of Osteopathic Physicians and Surgeons (MOAPS), seek to directly attack scope expansion in response to Missouri’s scope expansion bill. The Missouri Optometric Association shared important testimony during the first hearing on H.B. 2897 earlier this week. As written, this bill would allow optometrists to use injectable agents and perform additional surgical procedures, including laser surgery. The MOAPS-backed bills seek to narrowly define what types of surgery optometrists can perform, forcing patients back into ophthalmologist offices.
Another Missouri bill, H.B. 2556, which is also sponsored by MOAPS, and Washington State’s H.B. 2261, are attacking from a different front: titles. These bills aim to restrict how providers, including doctors of optometry, identify themselves. Both bills purport to bolster patient trust and confidence through provider transparency. But, in fact, they will impose strict limits for nonphysician providers, despite their comparable training and education.
AOA urges action
Although many ‘not-a-doctor’ bills have died in committee or failed to pass both houses, the unrelenting onslaught by medical groups calls for constant vigilance and ongoing relationship-building to combat future attacks.
John Whitlow, O.D., chair of the State Government Relations Committee (SGRC), says that while they have not seen as many such bills introduced so far in 2026, there is still plenty of time for new threats to reveal themselves.
“The opposition has become very good at disguising the ‘not-a-doctor’ bills so they look like common-sense measures,” Dr. Whitlow says. “When you get down into the meat of the bills, you find out that this is really bad for states and patients.”
As the aging population grows and the number of ophthalmologists shrinks, Dr. Whitlow says optometry is poised to offer much-needed expert patient care. “It’s not just a matter of numbers, though,” he says. “We have the education to do what we need to do, so that’s a battle we will continue to fight.”
Grassroots activism proves powerful
To prevent damaging bills from gaining strength after leaving committees, Dr. Whitlow says the most effective defense is grassroots activism.
“Knowing the legislators who are in a position to kill a bill is your best route for being able to defeat these efforts,” he says. “Across the country, we are improving our grassroots coalitions. We need to be on our toes for anything that comes down the line, but when we have solid grassroots actions, these bills tend to get defeated.”
Building relationships with legislators helps establish trust and allows for early responses to threatening bills. The AOA will continue to anticipate and respond to adverse legislation through the SGRC, but we need your help. Connect with your state optometric association today.