NAVCP Advocates for Allowing Stand-Alone Vision Plans to Participate in ACA Exchanges


TUCKER, Ga.—Even with the future of the Affordable Care Act (ACA) still unresolved, the Centers for Medicare & Medicaid Services (CMS) set out recently to obtain public input on ways to empower patients by improving their choices for care.

The National Association of Vision Care Plans (NAVCP), whose 18 primary member companies provide vision benefit coverage to more than 170 million people, is among those entities responding to the agency’s request, which is officially known as “Reducing Regulatory Burdens Imposed by the Patient Protection and Affordable Care Act & Improving Healthcare Choices to Empower Patients.”

In its comments to the agency, NAVCP said it “strongly believes” that increasing access to vision care services will lead to a more patient-centered health care system.

“Increasing opportunities for consumers to purchase vision coverage through the exchanges will satisfy an unmet need and demand of the current marketplace,” NAVCP noted in comments submitted last week. “There are two ways NAVCP believes this can be achieved: increasing awareness among plans of their ability to provide adult vision coverage and allowing stand-alone vision plans to participate in the exchanges.”

Stand-alone participation on the insurance exchanges by vision plans would “effectively extend the [essential health benefit] protection to adults and encourage other exchange plans to offer vision coverage,” NAVCP said in its comments. (Note that regulations governing the exchanges did not include the participation of stand-alone plans beyond pediatric dental,” NAVCP said.)

NAVCP said that some states considered allowing the inclusion of stand-alone plans, “but in most states consumers are not able to see offerings of all of our members when purchasing their exchange plans, limiting consumer choice.”

In addition, NAVCP noted that aligning plan design and carrier choice in the exchange markets with the employer-sponsored market is “a sound strategy for increasing exchange enrollment as well as increasing satisfaction across all demographics. In particular, the right benefit mix could convince more Millennials to enroll rather than pay the opt-out fine.”