6-29-2012

U.S. Supreme Court upholds majority of “Affordable Care Act”

California doctors of optometry maintain seat at the table because of COA

The Supreme Court of the United States (SCOTUS) found that the Affordable Care Act’s (ACA’s) individual mandate that requires individuals to buy health insurance or pay a fee is constitutional under the taxing power of the federal government. The court also found that while the expansion of Medicaid coverage under the ACA could go forward, the federal government cannot take away all Medicaid funding if states do not participate in the new law’s Medicaid expansion.

“COA is committed to providing access to primary eye care to all Californians. Today’s decision means that federal and state agencies will likely step up efforts to implement the ACA. COA will continue to work with other major stakeholders in the ACA discussion, including VSP, to ensure that stand-alone vision plans are allowed in the new state Health Benefit Exchange,” said Bill Howe, executive director of the California Optometric Association. Howe also noted that the Court decision represented a victory for the optometric profession and its patients, as the Harkin provider non-discrimination provision and the pediatric vision care essential benefit were clearly “the law of the land.”

All health plans in the nation will be required to include coverage for pediatric vision in 2014. While each state will separately define “pediatric vision,” California legislation, SB 951, authored by Senator Ed Hernandez, OD and supported by COA defines “pediatric vision” in California to include a comprehensive eye examination and eyeglasses coverage.

For the first time ever, health plans including ERISA plans, will no longer be able to discriminate against health care providers acting within the scope of their license. Senator Hernandez has proactively authorized legislation, SB 690, to ensure this historic anti-discrimination provision applies to state law. COA provided key testimony in committee hearings on this measure.

At the federal level, COA and the American Optometric Association (AOA) continue to work together to be a key component in implementation discussions. You can view AOA’s statement on today’s SCOTUS ruling here.

COA communicates regularly with state agency officials who are very sensitive to COA’s concerns about continuity of care issues that could occur if stand-alone plans are excluded from the state Exchange. COA is also meeting with employer groups, health plans and medical groups to educate them about optometry and explain clearly how we can improve access to quality care and save money by more effectively utilizing optometric services.

California has nearly 7 million uninsured, or about 20 percent of the population, according to the California HealthCare Foundation. As a result of this ruling, an estimated 4.6 million currently uninsured residents of California are expected to gain coverage in 2014 by purchasing subsidized health coverage through the new Health Benefit Exchange or through the expansion of Medi-Cal.

About the California Optometric Association

Established in 1899, the California Optometric Association is California’s oldest organized community for optometrists. COA is dedicated to ensuring the highest quality of health care for the public through the advancement of optometry. Learn more at www.coavision.org, www.Facebook.com/CaliforniaOptometric and www.Twitter.com/COA_Vision. Find an optometrist at www.eyehelp.org.