The Affordable Care Act and Optometry

OSU student Erica KellerBy Erica Keller, Ohio State University, AOSA Trustee-elect – Recently, Rick Cornett, Executive Director of the Ohio Optometric Association, came to speak at The Ohio State University College of Optometry about the Affordable Care Act (ACA)/Obamacare and how it will affect optometrists, both positively and negatively. More than 150 students came to listen, making it apparent that we have an interest in the future of our profession under the ACA. We want to know: What does this legislation mean for optometry’s future?

1. How will the increase in consumers with insurance benefit optometrists?
The increase in insured patients will allow more people to come to optometry offices and have coverage for services provided. Due to the legislative work of Sen. Tom Harkin (author of the Harkin amendment, which became part of the law), optometrists have been included in many health care plans and have not been discriminated against by major insurance providers who are looking to cut costs.*

2. The Harkin Law and Optometry
The Harkin Law provides patients easier accessibility to an optometrist of their choosing and prevents insurance carriers from keeping optometry services out of health care plans.* Unfortunately, this may not be the case forever. The introduction of the H.R. 2817 bill would undo the progress the Harkin Law has made in the advancements of gaining coverage under a health care plan and eliminating the need to have a stand-alone vision care plan.* Fortunately, optometry is a strong profession and the American Optometric Association is working hard to fight this newly introduced bill.

3. What can we do as students to ensure H.R. 2817 does not pass?
Donate to AOA-PAC through your school representative and, if you have the opportunity, go to Washington D.C. and lobby for optometry’s future. If this bill passes, it would allow insurance companies to implement plans that limit patient access to vision care by optometrists.

4. What is the future of pediatric vision care?
The ACA has implemented an essential health benefit (EHB) requirement that will include pediatric vision care as one of 10 essential benefits required in health care plans. This vision care benefit will be integrated into the plan as a whole and will allow children under 18 to have one comprehensive eye exam per year and material benefits.* Children who may have never had vision care insurance in the past will now be covered.

5. Medicaid Coverage Enhancements
Starting this year, Medicaid will extend its coverage to anyone with income under 133 percent of the federal poverty line.* This will allow citizens who are childless and without insurance to be covered when they would not have been eligible for government assistance previously.* It is up to each individual state whether they will accept this Medicaid expansion. The states that choose to participate will receive more money to manage the increase in Medicaid participants, but this does not mean that payments will increase for providers.* Contact your state association to find out what is being done and what you can do to help ensure fair payment to providers.

While the ACA has been a politically divisive issue, we must take measures to educate ourselves on its impact.
Students have a responsibility to ensure they are informed and proactive. Changes to health care in this nation are inevitable. We can choose to watch from the sidelines or make our message clear: we are part of the solution.

Erica Keller is a student at The Ohio State University School of Optometry and a trustee-elect for the American Optometry Student Association (AOSA). Her column appears in the Spring 2014 edition of Foresight, the AOSA magazine, and was reprinted with permission.

* “Top 5 ACA Changes for 2014: Are You Ready?” American Optometric Association, 8 Jan. 2014. Web. 02 Feb. 2014.

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