Dear Senator:

We, the undersigned free market organizations urge you to give Hoosiers access to innovative vision care options that Americans in nearly 40 other states already enjoy. It is well past time for Indiana to lift the ban on proven-safe ocular services will provide benefits not only to patients but also to taxpayers.

The challenges of providing health care that is effective and affordable to consumers, providers, and payers continue to confront policymakers in Indianapolis as well as Washington, DC. According to the Centers for Medicare and Medicaid Services, projections indicate that combined state and federal Medicaid expenditures between 2018 and 2027 for Medicaid will far exceed inflation, population growth, or overall total national health expenditures. In general, the Healthy Indiana Plan (HIP) remains an example for states attempting to wrestle with these challenges in their own jurisdictions.

Yet, when it comes to allowing consumers greater freedom of choice over whether to obtain eye exams and prescriptions online, Indiana provides far less inspiration. Currently 37 states allow such a choice, with careful oversight that preserves safety while providing savings in time and money. In the Hoosier State, however, certain interests in the optometric community have successfully blocked healthy competition with their convenient arrangement of being able to sell the eyewear they alone prescribe.

Successful health as well as fiscal outcomes will continue to depend upon wide-scale innovation in everything from medical services, to program management, to payment systems. This is certainly true with ophthalmic services and devices. Given the fact that HIP is one of the few Medicaid systems to offer vision care, technologies such as online eye exams and the freedom to purchase corrective products from a variety of sources are vital to fostering such innovation. Through telemedicine, underserved populations become better connected with providers. At the same time, Medicaid could reap potential savings due to efficiencies in delivering care online as opposed to large facilities that must accommodate patients as well as providers. In addition, long-term costs such as treatment for eye diseases are avoided because preventative care can be accessed more conveniently.

The dividends of ocular telemedicine to taxpayers extend well beyond Medicaid. Like many employers in the private sector, states and localities must contend with controlling the costs of health benefits for their workers while maintaining quality and consumer choice. The state of Indiana, for example, offers over half a dozen comprehensive health insurance plans, along with a vision care option. According to Indiana’s employee information website, the state contributes nearly 90 percent of the premium cost for a single worker’s vision plan and almost 40 percent for a family plan. Telemedicine, in this case for ophthalmic purposes, could make a meaningful difference in providing services that both the state’s taxpayers and its employees can afford.

Similar opportunities for improving care and reaping savings exist at the federal level, where taxpayers cover more than 70 percent of the premium cost associated with the Federal Employees Health Benefits Program. And while Medicare does not provide for routine vision exams or (in most cases) corrective devices, the development of new examination and purchasing venues will impact other areas of healthcare delivery. Citizens who might be deterred from maintaining their eye care because of inconvenient or expensive procedures could eventually suffer health problems that will rack up more Medicare treatment costs.

It is therefore imperative that Indiana become a leader, rather than a laggard, in online vision care innovation. As originally envisioned, Senate Bill 19 did so in a prudent, balanced fashion. Indeed, far from awarding telemedicine some massive advantage, one provision of the bill simply prevented the Board of Optometry from discriminating against ocular telehealth, ensuring that regulations affecting this sector are no harsher than those imposed on the rest of the industry.

Unfortunately, SB 19 has been amended to effectively continue the ban on ocular telemedicine, We hope you will resist these overtures to protectionism, which will only deny consumers, taxpayers, and governments the full benefits of ocular telemedicine. Instead, the Senate should adopt honest legislation that will foster competition, innovation, patient choice, and taxpayer savings.
Health and wellness cannot, and should not, be boiled down to solely to dollars and cents. Still, virtually every discussion of public policy involves to some degree the matter of how consumers, providers, and taxpayers can choose to put resources to their most effective use. Rather than enact flawed legislation that will maintain the status quo, please take this opportunity to enact a bill that will lift the ocular telemedicine ban. Hard-working Hoosiers deserve no less.


National Taxpayers Union
Center for Freedom and Prosperity
Council for Citizens Against Government Waste
Citizen Outreach
Taxpayers Protection Alliance

Coalition Urges Indiana Lawmakers to End the Ocular Telemedicine Ban