H.R.1521 - Dental and Optometric Care Access Act of 2025; DOC Access Act of 2025 (119th Congress)
Summary
H.R. 1521, the Dental and Optometric Care Access Act of 2025 (DOC Access Act of 2025), aims to amend Title XXVII of the Public Health Service Act to improve healthcare coverage under vision and dental plans. The bill seeks to ensure fair payment practices for doctors of optometry, dental surgery, and dental medicine. It also addresses the duration of limited scope vision and dental plans and restrictions on the choice of laboratories.
Expected Effects
The bill, if enacted, would change the relationship between healthcare providers (optometrists and dentists) and insurance plans. It aims to give providers more control over fees for non-covered services and choice of laboratories. States will be notified of their authority to enforce these provisions, with the Secretary of Health and Human Services stepping in if states fail to do so.
Potential Benefits
- Greater flexibility for doctors to charge patients for non-covered services.
- Protection for doctors regarding the duration of limited scope vision and dental plan agreements.
- Freedom for doctors to choose laboratories without restrictions from insurance plans.
- Increased state authority to enforce provisions related to healthcare coverage.
- Could lead to better access to dental and vision care due to improved provider-payer relations.
Most Benefited Areas:
Potential Disadvantages
- Potential for increased costs for patients if doctors charge more for non-covered services.
- Possible administrative burden on states to enforce the provisions of the Act.
- The election for doctors to be excluded from certain provisions could create confusion and complexity.
- State laws conflicting with the amendments may create legal challenges.
- The Act's complexity might lead to unintended consequences in healthcare coverage.
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution, as it aims to improve healthcare access. However, the Tenth Amendment reserves powers not delegated to the federal government to the states, which could be relevant given the bill's provisions regarding state enforcement and the exclusive applicability of state law. The Commerce Clause (Article I, Section 8) could be invoked to justify federal regulation of health insurance plans that operate across state lines.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).