When it comes to the impact of inflation across the country, rising costs are felt differently by the richest and poorest Americans. Any economist will tell you that inflation wreaks the most havoc on families with lower-level incomes. This is especially true for folks trying to navigate our healthcare system, where those with modest incomes, the elderly, and communities of color overwhelmingly bear the brunt of added healthcare burdens and expenses.

President Biden has identified one of the main culprits behind these growing problems and has committed to fixing it. Last year, the President issued an Executive Order on Promoting Competition in the American Economy which focused, in part, on combating excessive concentration, market power abuses, and harmful effects of monopoly and monopsony in healthcare. No part of healthcare is more in need of exactly this type of oversight and attention than the vision coverage and materials market.

The vision insurance that you get through your union or workplace typically covers an eye exam and glasses or contact lenses, no more, and often does so for a fairly small premium. That’s good, right? Well, not so fast. The low premium is misleading because the insurer knows that it’s going to make a lot more money off you and your family by essentially forcing you to buy the frames and lenses they make and use the labs and other services they own and operate – and often at break-even or a loss to your eye doctor.

The insurers are able to do this though the dominant market share they have in each community. They exert this force over your independent eye doctor though the plan-provider contract that the doctor must either sign as-is or be out-of-network for nearly everyone in your area. Within these “agreements,” the plan fixes prices for materials and services it doesn’t even cover and mandates that you and your doctor use specific labs (which the plans own) to turn the lenses you buy (that the plans make) into your personalized prescription. And, while they are busy emptying your pockets, they are squeezing service and materials margins for doctors too - meaning you and your doctor are both feeling the pinch.

A 2021 report released by health economists at Avalon Health Economics said the monopsony behavior exhibited by the nation’s two most dominant vision plans “is not the kind that’s good for consumers - it’s the kind designed to transfer operating margins from providers to plans without benefitting consumers.” Avalon went on to explain that the “plan mandates have another effect – they lead to higher overall costs for these consumers (with vision insurance) and, especially, for consumers without vision plan coverage (overwhelmingly those from traditionally underserved communities) as doctors are forced to compensate for the transfer of operating margins from doctors to the plans.”

Thankfully, U.S. Representative Yvette Clarke (D-NY) is leading an effort in Congress to confront these problems head-on and help increase access to needed eye care by first stabilizing and then helping to lower prices for consumers. It’s called the Dental and Optometric Care (DOC) Access Act, and it would prevent vision (and dental) plans from fixing prices on things the plans don’t cover and would provide patients and their doctors with the freedom to choose the lab that works best for them. Nearly every state in the country has passed a similar law covering vision and dental plans regulated at the state-level, but federally-regulated vision plans have been able to escape oversight – making Rep. Clarke’s bill essential and timely.

With increasingly tight household budgets and less and less resources to spend on growing healthcare needs, now is an important time for the President and Rep. Clarke and others in Congress to continue working to fix harmful imbalances in American healthcare, especially in the vision coverage and materials market. Signing the DOC Access Act in law would help unravel some of the power and dominance that the vertically integrated vision plan behemoths have amassed over the years and, in the process, help boost access to the eye and vision care we all need while ensuring that our families aren’t priced out of getting the high-quality vision correction we deserve. Let’s get this done.

Kevin Kimble is the founder and executive director of the Southern Christian Leadership Global Policy Initiative.