The American Optometric Association (AOA) has reported multiple legislative victories for the profession following the passage of H.R. 1, the “One Big Beautiful Bill Act” that was signed into law on July 4. The nearly 1000-page law reflects the Trump administration’s key economic priorities and includes several provisions that were championed by the AOA to support optometry practices nationwide.

Successes

• 2.5% Physician Pay Increase Secured for 2026: Among the most impactful outcomes for optometrists is the inclusion of a 2.5% increase in Medicare physician reimbursement for 2026. Alongside other medical associations, the AOA successfully reversed a previously scheduled pay cut through final-stage lobbying. The measure also lays groundwork for long-term structural reform to Medicare payment formulas by mandating annual positive pay updates in the future. 

• Tax Relief for Optometry Practices: AOA advocacy was also able to secure small-business tax provisions:

  • Permanent extension of the 20% small business pass-through tax deduction, which was previously set to expire in 2026.

  • Preservation of state and local tax (SALT) deductions at the pass-through entity level, following the defeat of a provision that would have eliminated them.

These changes are intended to stabilize financial planning and lower operational burdens for small to midsized practices. The AOA has compiled actionable tax law strategies and tips for optometry practices in a fact sheet.

Areas for Continued Monitoring

The law also introduces new dynamics in federal health programs that may affect optometry, the AOA noted:

• Medicare: Despite the temporary pay increase, the overall Medicare payment structure remains vulnerable to future cuts. The AOA will remain engaged as Congress explores permanent reform options later this year.

• Medicaid: Changes to eligibility and funding mechanisms could impact provider reimbursement and service coverage. “The AOA and state affiliates will continue working to ensure that optometry and essential eye health and vision care are not targeted,” they said in a press release. 

• Veterans' Health Care: Antioptometry lobbying groups continue to challenge the recognition and scope of practice for optometrists within the VA system. The AOA and its federal partners are continuing efforts to protect full practice authority in VA care settings.

• Research and Education Funding: Proposals to restructure federal research agencies may affect optometry researchers and academic institutions. The AOA will continue to advocate for safeguarding research funding streams.

• Student Loans: Recent changes to borrowing caps and repayment models will have long-term effects on optometry students and applicants. The AOA aims to ensure equitable treatment in future updates.

Exclusions

Despite bipartisan support and inclusion in earlier bill drafts, all Pharmacy Benefit Manager (PBM)-related provisions were stripped from the final text. Advocates now hope for inclusion in an anticipated end-of-year package, which could also open the door to Vision Benefit Manager (VBM) reforms.

Next Steps: AOA on Capitol Hill 2025

The AOA is urging continued engagement through its largest annual advocacy event—AOA on Capitol Hill 2025, which is scheduled for September 28 to 30 in Washington, D.C. Optometrists, students, and affiliate leaders are expected to participate in direct outreach to members of Congress to build on current momentum with optometry’s role in health care policy.