Vision Care for Kids Act

Key Points

Washington, DC-The U.S. House of Representatives has approved legislation that would provide financial resources for follow-up care of vision problems in uninsured children. The Vision Care for Kids Act of 2007 (HR 507) passed the House in mid-October and now is under consideration in the Senate, although it is uncertain when further action will be taken.

The bill was supported by an alliance of eye-care and educational groups that made compromises in an effort to move the measure forward after previous attempts in the last several years failed, said Eve Zartman-Ball, director of government and professional relations for the Vision Council of America (VCA). "We were finally able to get everything together that we needed to get it through," Zartman-Ball said. "The bill is designed to do something constructive in areas that we know will make a tangible difference, and that's why everybody agreed to support it."

"There was a lot of compromise in the bill introduced this year in the House," said Michael X. Repka, MD. "HR 507 is different from the two bills that were before the last Congress." Dr. Repka is a professor of ophthalmology and pediatrics at Johns Hopkins University School of Medicine, Baltimore, and also serves as secretary for federal affairs for the American Academy of Ophthalmology.

Under the proposed legislation, the Health and Human Services Department (HHS) would fund state matching grants for these services, acting through the Centers for Disease Control and Prevention; the House bill authorizes $65 million over 5 years. HHS would establish a medical advisory board to consider state proposals for the multi-year grants and review reports on how the funds were spent.

The bill is designed to give states flexibility in implementing their follow-up treatment or educational programs, rather than setting strict guidelines, Zartman-Ball said. "It's meant to be very open because what California needs is very different from what Arkansas needs," she explained.

With the grant money, states could provide comprehensive eye examinations by an optometrist or ophthalmologist for children identified by a healthcare provider or vision screener, and provide treatment or corrective services. States also could develop and disseminate educational material on healthy vision to parents, teachers, and healthcare professionals.

The bill would fill a void in funding vision care for working parents who can't afford private insurance but are ineligible for Medicaid. No mandate for vision care currently exists under the State Children's Health Insurance Program, although most states have some coverage.

"This is a bill to fill a gap in provision of eye care. It would apply to those children who don't have insurance coverage, the in-between group-not the very poor and not the well-off or privately insured," said Dr. Repka. "The bill would be a separate line item for developing programs to fill the gap in coverage to provide care-not necessarily the examinations-that children need after being found to have a problem.

"The presumption is that this bill will result in the prevention of a lifelong disability, and therefore it's a relatively economical intervention," Dr. Repka added.

Zartman-Ball said, "We are cautiously optimistic that we will get [the bill] through the Senate in either the other part of this session or in the second part of the 110th [Congress]."

Passage in the Senate could be more of a hurdle than in the House, Dr. Repka said, since the Senate as a rule scrutinizes proposed expenditures more carefully. Also, the political climate for additional spending on healthcare and other items has been volatile lately and could affect even bills such as this that have bipartisan support.