Dive Brief:

• A Health Affairs study published Tuesday questioned if a new law allowing hearing aids to be sold over the counter will improve hearing for low-income seniors without reimbursement of hearing care services by Medicare or including them as a mandatory benefit under state Medicaid programs.
• The research found that lower-income people with a hearing aid are twice as likely to experience "a lot of trouble hearing with their hearing aid, compared to their higher-income counterparts."
• The study, funded in part by the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health and from The Commonwealth Fund, was conducted by Amber Willink, an assistant scientist at Johns Hopkins, Nicholas Reed, who sits on the scientific advisory board for Clearwater Clinical and Shoebox Audiometry, and Frank Lin, a consultant for Cochlear Limited and Amplifon.

Dive Insight:

Study authors argued that while the Over-the-Counter Hearing Aid Act of 2017 will likely reduce the cost of and increase access to hearing aids, it will not close the access gap between low and higher-income patients to hearing services. 

The original Medicare statute excluded hearing aids and examinations from reimbursement, but certain Medicare Advantage plans offer coverage as a supplemental benefit. The report found 28 states provide some coverage of hearing aids under their Medicaid programs.

Currently, one-third of Medicare beneficiaries who reported using a hearing aid said they used related hearing care services in 2013. 

The study found in 2013, 27% of low-income Medicare patients dually eligible for Medicaid using a hearing aid still reported having a lot of trouble hearing. In comparison, only 11% of hearing aid users with incomes of 400% or more of the poverty line reported similar hearing troubles.

"Existing barriers to device owners’ receiving hearing care services are likely to be exacerbated when over-the-counter sales further separate the purchase of hearing aids from payment for supportive services," Reed and Lin said. "Hearing care services provided by audiologists or hearing aid dispensers will likely remain an important determinant of success in efforts to increase hearing aid use, even as technology continues to advance."

The entrenched hearing aid industry has spent heavily on lobbying the government as FDA develops a proposed rule slated for a November 2019 release.