Dentists, optometrists gain pricing power; patients may pay more for uncovered care.

What it does

This bill amends federal health insurance law to allow dentists and optometrists who participate in insurance networks to charge patients for uncovered services at their usual rates (the same amount they charge uninsured patients), rather than being restricted by insurance contracts. It also prevents insurers from controlling which labs dentists use, requires multi-year network agreements to be renewed with provider consent, and allows dentists and optometrists to opt out of these rules for a single year at a time.

Why we flagged it

The bill's core mechanism is to remove insurer contractual restrictions on what dentists and optometrists can charge for uncovered services and which labs they must use. This is functionally a deregulation of provider pricing within the insurance market, framed as an 'access' measure but operationally benefiting providers at the expense of cost control.

What the text implies

• Patients with limited-scope dental/vision plans may see significant out-of-pocket cost increases for services outside their plan's coverage, as providers can now charge full usual-and-customary rates rather than negotiated discounts.
• The lab-choice provision removes a cost-containment tool insurers use; dentists can now select higher-cost labs without insurer approval, potentially raising costs for patients and insurers.
• State law is given exclusive jurisdiction, creating a patchwork of enforcement and potentially allowing states to weaken or eliminate these protections entirely.
• The opt-out mechanism allows providers to escape the rules for a single year, creating instability in coverage terms and potentially allowing providers to cherry-pick favorable years.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

While the bill frames itself as improving access, its operative effect is to reduce insurers' ability to negotiate lower prices for uncovered services and to control costs through lab restrictions. Patients enrolled in these plans will likely face higher out-of-pocket charges for services outside their plan's coverage, as dentists and optometrists can now charge their full usual-and-customary rates rather than negotiated network rates. The bill shifts pricing power from insurers (who negotiate o

Who stands to gain

• dentists and dental practices
• optometrists and optometry practices
• dental and vision laboratories (via unrestricted selection)

Named in the bill

dentists, optometrists, dental surgeons, dental medicine doctors, health insurance issuers, group health plans, limited scope dental plans, limited scope vision plans, laboratories, Secretary of Health and Human Services, State insurance regulators, Public Health Service Act Title XXVII

Where it stands

121 cosponsors: 70 Democrats, 51 Republicans.

• Feb 24, 2025 — Introduced · Congress.gov: “Introduced in House”
• Feb 24, 2025 — Referred to House Committee on Energy and Commerce · Congress.gov: “Referred to the House Committee on Energy and Commerce”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

19 lobbying clients named this bill on 30 disclosure filings across 3 quarters, Dec 2025 to Jun 2026. Those filings disclosed $5,580,510 in lobbying spend. A filing names 4 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 96% of bills with at least one filing.

Buddy Carter, the sponsor, reported $988,325 in PAC receipts in the 2026 cycle.

• American Optometric Association — $2,350,000 on 2 filings
• American Dental Association — $593,780 on 2 filings
• Guardian Life Insurance Company of America — $520,000 on 1 filing
• Metlife Group, Inc. — $370,000 on 1 filing
• Essilorluxottica USA Inc. — $330,000 on 2 filings

Lobbying Disclosure Act filings through Jul 21, 2026. A filing shows who paid to lobby on a bill it names, not what changed.