• Prohibit health plans, including self-insured ERISA plans, from discriminating against groups of providers, including optometrists, chiropractors, and other providers.
• Include vision care for children as an essential health benefit. Current vision care plans will be able to partner with major health plans for children’s eye care.
• Safeguard existing vision coverage provided through stand-alone vision care plans.
• Create state-based health insurance exchanges (marketplaces where consumers can shop for and purchase health insurance). State insurance laws will fully apply to each of the 50 state health insurance exchanges through which millions of Americans will purchase coverage when the bill takes effect.
• Create a 2.3% excise tax on medical devices sold by manufacturers and importers—however, it specifically exempts retail-purchased medical devices, including eyeglasses, contact lenses and hearing aids.
• Establish a new tax on high-cost health plans (starting in 2018)—however, it specifically excludes the cost of vision and dental coverage.
• Aim to close the Medicare Part D coverage gap, or “donut hole.” Starting this year, people who fall into the donut hole will get a $250 rebate. In 2011, they will get a 50% discount on brand name drugs. Under this plan, the donut hole is expected to close by 2020, and 75% percent of drug costs will be covered.
Further details of the bill need to be clarified as the legislation is implemented.
“Although this victory affords an opportunity to appreciate how optometry’s advocacy efforts have progressed, it doesn’t mark the end of the profession’s fight for its patients or to proactively define its own future,” says Jon Hymes, director of the American Optometric Association’s Washington Office.
