To: Representative Jeffrey Sanchez, Chairman Committee on Public Health

From: Heidi L. Reed, Commissioner, MCDHH

Date: December 21, 2009

Re: HB3598, An Act to Provide Coverage for Hearing Aids

On behalf of the Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH), this testimony is presented to support of the intent of HB3598, an Act to Provide Coverage for Hearing Aids. As with any bill that mandates a new insurance benefit, it is necessary to find the proper balance between the benefit of the mandate and the cost to the health care system. As the Commissioner of MCDHH I know well the need for the benefit this bill will provide but the Administration has not yet analyzed the costs of this bill and I feel we must understand the costs to the system before making a final determination about the bill. I understand the Committee requested an analysis from the Division of Health Care Finance and Policy and I look forward to the findings from that cost impact review.

Having said that let me explain what I know to be the need for this bill.

HB3598 will result in a system commitment to significantly and positively impact independence, employment, safety, and healthy living of deaf and hard of hearing individuals throughout the Commonwealth by requiring healthcare insurance coverage of hearing aids.

The population of potential hearing aid users resides in every locality, and in every racial and ethnic community within the Commonwealth. It is estimated that 546,000 people, or 8.6% of the population of Massachusetts is deaf or hard of hearing. Without an official census, these figures are close to national percentages. The nationwide incidence of hearing loss in American society is discussed by Ear Info, which reports:

  • One out of 10 Americans has a hearing loss
  • 29% of people over age 65 have hearing loss
  • However, the majority (65%) of people with hearing loss are below retirement age
  • One out of eight 50-year-old Americans have hearing loss
  • 15% of "baby-boomers" have hearing loss
  • One out of 12 30-year-old Americans already has hearing loss
  • And, of the 10 million Americans aged 45 to 64 who have a hearing loss, 6 out of 7 do not yet benefit from wearing hearing aids

The impact of hearing loss on the health of this population is mentioned by the National Academy on an Aging Society: "Challenges for the 21 st Century-Chronic and Disabling Conditions," December 1999, which states that "people with hearing loss are more likely to report symptoms of depression, dissatisfaction with life, reduced functional health, and withdrawal from social activities. And further, at that same time, it was estimated that untreated hearing impairments cost the U.S. economy $56 billion in lost productivity, special education, and medical care - an annual per capita tax of $216." Untreated hearing loss continues to impact our constituency today, even more so as the population ages.

Depending on the cause of an individual's loss of hearing, that individual may be able to use a hearing aid to take advantage of residual hearing, to increase ability to detect speech, and to detect environmental sounds. The ability to use a hearing aid can enable a person with a hearing loss to more effectively participate in economic, social, educational, cultural, and related aspects of community living. Healthcare coverage for treatment with hearing aids varies by insurer and HMO; and ranges from no coverage, to minimal coverage, to near full coverage. For the insured person, cost is among the major factors determining whether or not to obtain a hearing aid. The American Speech-Language-Hearing Association, (ASLA) 2008 edition, "Incidence and Prevalence of Hearing Loss and Hearing Aid Use in the United States" notes that "Barriers to hearing aid use are complex and multi-factorial involving, among other things, a lack of system commitment to utilization of hearing aid and hearing aid design, fit issues, and price of aid."

The ASLA also stated that "all customer satisfaction with new hearing instruments is 77%, placing this product in the top third of products and services in the United States." The message here is that a hearing aid can be an effective communication access device for a high percentage of users, but is inaccessible to many because of cost and because of lack of recognition as a treatment option.

MCDHH averages 67 inquiries per month from people seeking assistance in obtaining hearing aids as a result of limited or no health insurance coverage. We have seen the cost of hearing devices rise sharply with recent advancements in technology. The average cost per person for a hearing aid in FY "05 was $872, in FY "06 was $1539, in FY "07 $1658, and in FY '08 the average cost was $2616. These rising costs are out of reach for many subscribers of healthcare plans which do not adequately recognize hearing aids as a needed treatment option.

MCDHH strongly supports the intent of HB3598, and the subsequent systemic commitment to recognizing hearing aids as a viable treatment option with significant benefits to health and wellbeing of deaf and hard of hearing people across the Commonwealth.

This information is provided by the Massachusetts Commission for the Deaf and Hard of Hearing.