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Delaware Assistive Technology Initiative

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Volume 11, Issue 4: Fall 2003

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States Take Legislative Efforts
to Fund Hearing Aids

Tom McDonough, DATI Funding and Policy Specialist

In the Spring 2003 issue of The AT Messenger, I wrote about the benefit that hearing aids can provide to persons with hearing impairments. I also provided some general funding information and noted many private insurance companies do not cover hearing aids. In this issue, I will address the legislative efforts that have been undertaken throughout the United States to remedy this situation.

DATI research indicates that only five states (Oklahoma, Kentucky, Maryland, Connecticut and Missouri) have laws requiring some form of mandated insurance coverage for hearing aids. However, there are some variations in the age limits, amount of coverage and other conditions. In 2001 and 2002, Maryland, Kentucky and Oklahoma enacted laws requiring health insurers to cover hearing aids for children up to age 18. Connecticut passed a law covering children up to age 12. With the exception of Connecticut's law, which does not address this issue, the other states' laws all mandate that hearing aids be prescribed, fitted and dispensed by a licensed audiologist. Connecticut's law covers the cost of a hearing aid (up to $1,000) every 24 months, while Kentucky and Maryland's laws cover the cost up to $1,400 per hearing aid every 36 months. Kentucky and Maryland also provide that, in the case of more expensive hearing aids, the consumer may choose a higher priced hearing aid and pay the difference in cost. Oklahoma's law, which broadened an earlier law covering those up to age 13, goes further than the other states in placing no limit on the amount to be paid per hearing aid. However, Oklahoma does restrict use of this benefit to once every 48 months.

Several years ago, Missouri enacted a law requiring insurance coverage for infant hearing screenings and the cost of initial amplification devices (hearing aids). This year, however, efforts in Missouri to pass legislation requiring insurance coverage of hearing aids for children up to age 19 were unsuccessful.

The experience of advocates in other states has not been so positive. There have been efforts in at least 12 other states to pass hearing aid legislation during the last few years. Some bills proposed to cover only children, while others intended to cover adults as well. Earlier this year in Connecticut, there was an effort to extend coverage to children 13 years and older but, it appears to have died in a legislative committee. Most proposed bills in other states were similar to the Kentucky, Maryland or Oklahoma models with respect to the maximum amount (or no limit on maximum amount) and frequency of coverage. None of these bills have been successful, with most stalling in a legislative committee. A bill passed by the Colorado Legislature last year mandating insurer coverage of hearing aids was vetoed by the Governor. A number of explanations have been given for the lack of advocate success in other states: post 9/11 state budget crises, rising health insurance costs, partisan politics and philosophical objections. An effort to enact federal legislation requiring insurance coverage for hearing aids also died in Committee.

Given the above picture, what should Delaware consumers seeking legislative action on this issue keep in mind? First, as Oklahoma explicitly noted in its statute, these laws apply only to State-regulated health insurance plans, which are outside the scope of the federal Employee Retirement Income Security Act (ERISA). The practical impact of this ERISA exemption is that any state law would probably cover only a minority of health insurance plans in Delaware. Secondly, a bill requiring all State-regulated insurers to cover hearing aids would necessitate numerous amendments to the Delaware Code. Finally, it would be realistic to expect that many of the same objections which impeded legislative efforts in other states would surface in Delaware as well. All of this is not meant to suggest that any effort in Delaware to mandate insurer coverage of hearing aids would be futile. However, proponents of such legislation would have to offer a reasoned projection of the fiscal implications, both in terms of costs and benefits, in order to justify this type of legislative action.

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