Hearing Aid Mandates: Striving for the Tipping Point 

By Sara Kennedy, H&V Headquarters

“The tipping point is that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire,” says Malcolm Gladwell in his book The Tipping Point. In the world of hearing aid legislation, that tipping point may be this season. According to Let America Hear, a grassroots organization supporting hearing aid related advocacy efforts founded by parent Kelly Jenkins seven years ago, 25 states have passed legislative mandates requiring private insurance companies to cover the cost of children’s hearing aids and other devices and therapies. In the past few years, many parent advocates and Deaf/hard of hearing adult groups have started new efforts in their home states.

Idaho’s new rule covers hearing aids for children every three years and 45 hours of therapy during the first year. Some recent laws include adults or target state employee health plans. Last year, Maine passed a law making it just the fifth state to require private health insurers to provide hearing aid benefits to their subscribers (previously their law covered children only). While the first states took years of effort to get their bills passed, more recent efforts are going faster, building on the success of earlier states.

What’s new in the bills this session? Vermont is spearheading legislation that also covers all ages and adds more. As the last New England state without a mandate, the Vermont Chapter of Hearing Loss Association of America (VT HLAA) is partnering with the state AARP chapter (the American Association of Retired Persons) to get the word out about SB 320. Rebecca Chalmers, VT HLAA, notes that “we are highlighting recent research connecting untreated hearing loss to increased risk for dementia and higher lifetime healthcare costs and more.” The bill requires Vermont to edit its list of Essential Health Benefits to include hearing aids, remote microphones as an adjunct to hearing aids, and aural rehabilitation.

In the national arena, HR 5484 or Ally’s Act seeks to amend the Affordable Care Act to require national coverage of unilateral or bilateral auditory implants (including osseointegrated, external sound processors and cochlear implants). Upgrades as medically necessary and/or replacement/repairs every five years for children and adults would be covered. Coverage includes surgical costs, audiology evaluations, activation, fitting and aural rehabilitation. With six sponsors now, Ally’s Act was first introduced in December 2019 in the House by Rep. Joe Neguse in Colorado and named after Ally Tumblin, daughter of Ear Community founder Melissa Tumblin.

What are the barriers to current legislative efforts? Lack of awareness may be the first hurdle. When advocates from Colorado Hands & Voices and others were lobbying for the mandate in Colorado, the average citizen had no idea that hearing aids were not a covered benefit for children (let alone for adults) and that upkeep costs or new hearing aids every 3-5 years were a huge financial burden to most families with private insurance before that bill passed in 2008. Insurance companies will cite increasing costs as a barrier, yet actuarial estimates point to a very low rise in premiums due to the low incidence nature of deafness, and the high benefit to early amplification if families choose. Politicians may have been elected on a platform of keeping down health care costs, and hesitate to sponsor bills that create mandates. None of these bills touch self-insured plans (common in school districts or utility companies). However, some businesses change their employee health coverage as their state legislatures join the hearing aid coverage movement. The cost of  lobbying is also prohibitive to many grassroots parent groups, but nothing is more powerful than a personal story well told to legislators, getting to know a legislator, working on their campaigns, and multiplying those efforts by 20-100 parents and deaf or hard of hearing adults, teens and children who can share direct experiences about their own need for equipment and the burden of maintaining a series of quality hearing aids and other amplification in their lives. Getting hearing care listed as one of the Essential Health Benefits central to the Affordable Care Act (ACA), as vision care is for children, is a national hurdle. When the ACA passed, hearing aids were only covered in states that had already passed a legislative mandate. (See sidebar for additional bills to watch this legislative season.)

Advocates from any group can learn more about hearing aid legislation and the ins and outs of lobbying through Let America Hear. “When my friend Sara and I worked on our bill in Georgia, we learned from wonderful professionals and parents across the country. I started Let America Hear to create a community so that each state is not constantly reinventing the wheel when it comes to introducing this type of legislation,” says Jenkins. Today, the Let America Hear community (LAH) includes organizers from 27 different states, helping new states onboard as they develop grassroots campaigns and draft bill language. LAH also hosts collaborative videoconference calls so organizers can meet one another and share ideas.

Editor’s note: Find these efforts and contact people in your state (or start one) by contacting Let America Hear at info@letamericahear.org, https://www.letamericahear.com/ . A private Facebook group for organizers is encouraged for information-sharing. Thanks to LAH for assistance with this time-sensitive article.

H&V Communicator – Spring 2020