A federal court in Texas has blocked the enforcement of a 2023 law that restricted vision care plans’ patient communication on pricing and provider information.
The ruling was made late last month in the U.S. District Court for the Northern District of Texas.
Let’s start with a look at this legislation.
Signed into law in June 2023, House Bill (H.B.) 1696 is a consumer protection law that established “first-in-the-nation reforms” regulating how vision care plans interact with optometrists (ODs) and other eyecare providers (ECPs).
But more specifically: The legislation was designed to limit the power of vision insurance and other managed care plans over ODs and patients—ensuring ECPs are treated fairly and patients have greater freedom to choose their providers.
What kind of restrictions were these?
See here for the bill in its entirety. Among the stipulations:
- Vision plans restricted from discriminating against ODs or therapeutic ODs compared with other ECPs.
- Includes restricting patients from seeing an OD within network or excluding ODs from networks without justification, as well as treating ODs differently from ophthalmologists based solely on their degree
- Vision insurance companies restricted from steering patients toward specific providers or retailers (such as corporate chains or a company-owned retail location or website)
- Vision plans restricted from interfering with ODs’ practice operations
- Includes forcing ECPs to use certain suppliers, requiring unnecessary patient medical data for routine vision claims, and gaining control over a practice's electronic health record (EHR) system
- Limitations placed on certain contract practices between vision plans and ODs
- Plans not permitted to reimburse providers differently based on affiliations, business choices, or products; also required to give 90 days’ notice before changing an ECP’s contract or payment
And what was the OD response when it was passed?
Following advocacy efforts from both the American Optometric Association (AOA) and Texas Optometric Association (TOA), then-TOA President Jennifer Deakins, OD, said in July 2023 coverage that “the days of vision plans paying lip service to our profession while doing whatever they please are over.”
- “Texas’ legislators have decided that giant conglomerates aren’t to have the final say between doctors and patients in local Texas communities, and we agree,” Dr. Deakins stated.
- “On the contrary, the new Texas law ensures that optometric practices are protected from anti-competitive behavior by the plans.”
… so that brings us to these latest developments: the lawsuit.
Indeed. Initially filed in 2023 by multiple plaintiffs—Healthy Vision Association, the National Association of Vision Care Plans (NAVCP), VSP Vision, and Visionworks, among them—last year, the lawsuit argued that H.B. 1696:
- Violated the First Amendment—among other constitutional protections such as their rights to commercial speech, freedom of association, and equal protection under the First and Fourteenth Amendments—due to its restrictions on what vision plans could say to their members.
Did they note any specifics?
They did. Within this argument, the plaintiffs called out key restrictions preventing vision plans from:
- Promoting discounts or savings available at certain providers
- Informing members about lower-cost in-network providers
- Identifying specific providers offering better benefits
- Encouraging patients to use affiliated providers or retailers
They claimed that H.B. 1696 limited truthful commercial speech and prevented consumers from receiving information that could potentially help them choose affordable care.
Got it. Now to this injunction.
Let’s take note: A preliminary injunction against H.B. 1696 was upheld last May, temporarily blocking parts of the law while the case proceeded.
- The court determined at that time that the law appeared to improperly restrict commercial speech.
Fast forward to February 2026 (the most recent ruling): A U.S. District judge granted a summary judgment—a permanent injunction—in favor of the plaintiffs, determining that H.B. 1696 violated the First Amendment.
… why?
In support of the plaintiffs’ argument:
Because the law prevented vision plans from providing truthful information about providers and prices—and would have forced consumers (patients) to remain “misled or uninformed for their own protection,” according to the ruling.
- See here (page 8) for all three reasons behind the court’s decision.
Let’s talk feedback.
Mixed reviews have trickled in over the court’s decision, with vision plans voicing their support and ODs—including the AOA and TOA—expressing disappointment.
Case in point: VSP Vision (one of the plaintiffs) referred to it as a “landmark ruling.”
- “By upholding the right of consumers to make their own informed decisions, this ruling empowers individuals to access affordable, high-quality eye care and eyewear in a destination that best suits their needs,” stated Michael Guyette, VSP Vision president and CEO.
And from the other side?
In the AOA’s statement on the court decision, President Jacquie Bowen, OD, noted:
“It appears the (VBM) industry is pointing to a temporary reprieve through the courts for thoroughly anti-patient, ‘steering and tiering,’ tactics … What they refuse to discuss is resolving patient and doctor complaints and the growing nationwide momentum for VBM accountability.”
In response to this: Dr. Bown stated the AOA and affiliate efforts will continue to advance state legislation, federal legislation, and Congressional and government agency investigations focused squarely on abusive VBM policies—“while continuing to expose an out-of-control industry that appears to invest in lawyers, lobbyists and loopholes instead of patient care, health awareness and doctor-patient decision-making.”
How about the state-level optometric response?
TOA released a statement reading, in part: “While we respect the judicial process, this ruling undermines Texas’ efforts to curb monopolistic behaviors in the vision benefits industry that drive up costs, limit provider networks and erode patient choice and access.”
- Moving forward: TOA plans to continue its ongoing efforts with state legislature and its partners to “explore all available options to restore and strengthen protections for Texas consumers and doctors of optometry.”
*Disclaimer: The information provided in this article does not and is not intended to constitute legal advice; instead, all information, content, and materials available herein are for general information purposes only.