Vt. state lawmakers consider bill requiring private insurers cover hearing aids
Untreated hearing loss isolates millions of Americans. President Joe Biden’s efforts to expand Medicare to include hearing aids has stalled in Washington. But in Montpelier, lawmakers are currently considering a bill that would require some private insurance plans in Vermont to cover them.
Advocates for the hearing impaired are pushing for its passage saying the disability is more common than people realize.
Rebecca Chalmers was one of several people testifying last month in front of members of the Vermont House Committee on Health Care. She’s a scientist who lives in Rockingham. She’s also someone with hearing loss.
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"We're here because insurance companies target my disability group for total exclusion of one of the most common health care needs,” she told lawmakers.
According to the advocacy group Hear! Hear! Vermont, hearing loss affects about 17% of all Vermonters. It’s an invisible disability that becomes even more common as people age.
Sophisticated hearing aids that require professional fitting with an audiologist can cost anywhere from $1,000 to $6,000 a pair, or more.
Medicaid covers the cost for low-income Vermonters, but most private insurance companies in the state, as well as Medicare don’t.
That gap in coverage is a big reason why Vernon resident Tim Arsenault put off having his hearing checked. A long-time radio broadcaster, he began noticing hearing problems in his mid-50s.
"I was a little embarrassed,” admitted Arsenault, who's now 65. “But I also was very concerned about the cost because in my case, my hearing aids cost a little over $3,000. And I didn't have that kind of money lying around in the house.”
Arsenault said the hearing aids he finally did purchase have made a big difference, but he had to use a credit card to buy them.
Many others with hearing loss simply do without. According to the Hearing Loss Association of America, only about 20% of those who might benefit from treatment seek help.
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That’s unacceptable to Ruby Baker, who heads Hear! Hear! Vermont. She said if left untreated, hearing loss makes it harder to work. And studies show it increases a person’s chances of falling, of developing dementia and of feeling isolated.
“We know that social isolation is as bad for you as smoking, obesity or physical inactivity,” Baker said.
It’s why she's encouraging Vermont lawmakers to pass legislation known as H.266. It would require many private insurance plans in Vermont to cover hearing aids.
Hinesburg Rep. William Lippert chairs the House Health Care Committee that’s been hearing testimony on the bill.
"What we're trying to do is to work with the Hear! Hear! Coalition, to try to ensure that hearing aid services are included in as many parts of this health insurance landscape in Vermont as possible,” he said.
Ruby Baker with Hear! Hear! Vermont said the bill would impact most people who "buy insurance independently from Blue Cross Blue Shield or MVP Health Care or get a plan on the exchange."
If you get your insurance through your job, she said whether or not hearing aids are covered by your policy may depend on the size of your employer and whether their plan is state-regulated.
In early March, the Green Mountain Care Board weighed in on hearing aids. The board regulates insurance rate increases in Vermont and works to control health care spending.
It approved a proposal to include hearing aids for Vermont insurance plans offered under the Affordable Care Act.
That means Vermont now has permission to apply to the federal government to add hearing aids to the the list of essential health benefits without incurring additional state costs.
It’s a change that will go into effect in 2024.
"You know, if you can't hear, it's pretty hard to function. So it seems like a very reasonable benefit to include in the essential health benefits package."Kevin Mullin, Chair of the Green Mountain Care Board
Board Chair Kevin Mullin said among northeastern states, Vermont and Pennsylvania are the only two that don’t currently include hearing aids as an essential health benefit.
“We have one board member with hearing aids, and so we understand that, you know, if you can't hear, it's pretty hard to function," continued Mullin. "So, it seems like a very reasonable benefit to include in the essential health benefits package.”
According to Mullin, the hearing aid coverage would cost between 30 and 60 cents per member per month. Initially, he said only about 75,000 Vermonters would qualify and he’s hopeful that recently enhanced federal subsidies would continue to offset the price increase.
"What we're basically ensuring is that the individual and small group insurance markets will have this," Mulllin said. "It's yet to be determined, but you have to start somewhere, and if this group is getting the benefit, it's hard pressed for others to not provide the benefit.”
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In other words, once some insurance plans cover hearing aids, others, like private plans run by large companies, which are not state-regulated, would likely follow suit to stay competitive.
Sara Teachout, a spokesperson with BlueCross Blue Shield of Vermont, said they haven’t taken a position for or against the addition of hearing aids. But in a
letter to lawmakers, she said the company is concerned about the large number of proposals that will increase premiums for consumers, including: rising hospital costs, new information technology requirements and expanded mental health coverage. Hearing aids will add another.