January 2015
Volume 56, Issue 1
Free
Letters to the Editor  |   January 2015
Author Response: What to Do About Racial Disparities in Access to Glasses Among Children in the US?
Author Affiliations & Notes
  • Karla Zadnik
    1The Ohio State University College of Optometry, Columbus, Ohio, United States
  • Nathan G. Congdon
    2State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Division of Preventative Ophthalmology, Guangzhou, China.
Investigative Ophthalmology & Visual Science January 2015, Vol.56, 106. doi:https://doi.org/10.1167/iovs.14-16055
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      Karla Zadnik, Nathan G. Congdon; Author Response: What to Do About Racial Disparities in Access to Glasses Among Children in the US?. Invest. Ophthalmol. Vis. Sci. 2015;56(1):106. https://doi.org/10.1167/iovs.14-16055.

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      © ARVO (1962-2015); The Authors (2016-present)

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  • Supplements
The recent editorial appearing in IOVS entitled “What to do about racial disparities in access to glasses among children in the US?"1 omitted an important consideration. When the article called for the United States to “guarantee all children access to basic, inexpensive spectacles,” it failed to reference an important new part of the Affordable Care Act (ACA) highly relevant to the goal of improving access to eyeglasses for all children who need them. The essential vision benefit of the ACA, in fact, guarantees access to eye examinations, and in most cases, eyeglasses, for most children in the country. This represents an important step forward and should have been mentioned in the editorial. 
Some limitations of this important new legislation deserve mention too: 
  • •   
    Only companies with fewer than 50 employees (and in 2016 fewer than 100) must offer the essential benefit. Those who are self-insured or working for larger companies are not covered. (It is presumed, but not specifically guaranteed, that health plans offered by larger companies will likely include these same benefits through vision-specific insurance.)
  • •   
    Health plans that are “grandfathered” in under the ACA are not required to offer the benefit.
  • •   
    The essential benefit is not considered a “preventive service,” so co-pays may apply, which could create barriers for families of limited means.
  • •   
    The inclusion of a specific benefit for eyeglasses varies from state to state, though the large majority of states appear to cover eyeglasses.2
Despite these provisos, the essential vision benefit for children certainly should bring the United States closer to the goal of providing access to eyeglasses for all children needing them. As the ACA is fully implemented, oversight and further research to evaluate this progress and the effect, if any, of co-pays on uptake, will be of great value. 
References
Congdon N. What to do about racial disparities in access to glasses among children in the US? Invest Ophthalmol Vis Sci. 2014; 55: 7006. [CrossRef] [PubMed]
Department of Health and Human Services Center for Consumer Information and Insurance Oversight. Available at: http://www.cms.gov/CCIIO/Resources/Data-Resources/ehb.html. Accessed November 10, 2014.
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