House Antitrust Subcommittee Scrutinizes Vision Benefits Managers

Rep. Scott Fitzgerald (R-WI), chairman of the House Judiciary Committee’s antitrust subcommittee, sent a letter to VSP Vision Care on Monday requesting a briefing about the company’s vertical integration strategies. According to a statement cited by the Washington Examiner, critics argue that VSP’s business practices put pressure on independent optometrist offices and limit consumer choice. VSP is the largest vision insurance provider in the United States, with about 82 million enrollees—more than two-thirds of the vision insurance market. In 21 states, the company holds more than 80 percent of the market share.

The letter signals an escalation in congressional scrutiny of the vision insurance industry. Per a statement from Fitzgerald, vertical integration practices by vision benefits managers may reduce competition, ultimately driving up costs, narrowing patient options, and restricting access to independent providers. His correspondence highlighted industry concerns that insurers frequently control or partner with downstream providers, including optical labs, frame and lens manufacturers, software firms, and optometry practices.

VSP has been at the center of these debates, accused of bundling and “tying in” arrangements that require optometrists to contract exclusively with certain vendors in order to remain in-network. According to Fitzgerald’s letter, such relationships may incentivize companies to “self-preference, steer, bundle, and tie” products and services, restricting independent practitioners’ flexibility.

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The inquiry builds on earlier congressional actions. In August 2024, House Oversight Committee Chairman James Comer (R-KY) contacted then-Federal Trade Commission Chairwoman Lina Khan about alleged anticompetitive practices in the sector. Comer followed up in November 2024 with a request to then-Attorney General Merrick Garland to open a federal investigation.

Concerns about VSP’s market dominance have also surfaced in the courts. In 2023, California-based Total Vision sued the company, alleging it was required to purchase significant quantities of frames and lenses from VSP suppliers. The case was settled in the summer of 2024 but is still referenced by lawmakers as an example of the challenges tied to vertical integration in the industry. Fitzgerald’s letter cited the complaint’s assertion that VSP’s widespread influence made participation in its network essential for any optometry practice seeking to remain competitive.

The American Optometric Association has also clashed with VSP. Three months ago, the AOA issued a cease and desist letter, accusing the company of maintaining a pattern of anticompetitive conduct. Dr. Steven Reed, president of the AOA, said in a June press release that VSP’s model “sets up a downward spiral that ends badly for all involved.”

Fitzgerald has asked VSP to provide a detailed briefing to committee staff on its policies, including information about bundling, tying, and any conditions placed on independent optometrists to stay in-network.

Source: Washington Examiner