Although the original $3.5 trillion infrastructure bill has been cut in half, the $1.75 trillion Build Back Better framework now being considered by Congress includes expansion of Medicare coverage for hearing aids and services, according to the White House.
To reduce the estimated cost of the legislation, the original proposal for the infrastructure bill to include vision and dental care has been dropped. As noted in a previous Hearing Review article, the Congressional Budget Office (CBO) had reportedly affixed a 10-year price tag of $30 billion for vision care, $89 billion for hearing care, and $238 billion for dental care for the previous Medicare Hearing Act of 2019 (H.R. 4618).
On October 28, Democrats in the US House released text describing the proposed inclusion of hearing care services in the Build Back Better Act (H.R. 5376, Section 30901, pgs 582-590), which is described as “President Biden’s plan to rebuild the middle class.” Relative to hearing healthcare, perhaps the most noteworthy change in the original text is the inclusion of “qualified hearing aid professionals” in addition to “qualified audiologists.” A major concern for some in the previous bill’s wording was the possible exclusion of hearing aid specialists and ENTs. The new text includes persons “licensed as a hearing aid dispenser, hearing aid specialist, or related profession by the State…[and who] meets such other requirements as the Secretary [of Health and Human Services] determines appropriate…”
Under the current provisions, hearing aids could be furnished not more than once per ear during a 5-year period for people with severe and profound hearing losses, and would exclude from Medicare the upcoming FDA over-the-counter (OTC) hearing aid product class. Any hearing aid covered by Medicare would require written recommendation from a physician, qualified audiologist or hearing care professional, physician assistant, nurse practitioner, or clinical nurse specialist. The bill also appears to include some aural rehabilitation and treatment services, and categorizes hearing aids as a prosthetic device (as opposed to durable medical equipment)—two extremely important provisions for dispensing professionals and the hearing industry.
Other top priorities for hearing healthcare is the ability for patients to be able to “top-up” or upgrade their hearing aids to an appropriate technology level over the Medicare provision limit.
The Build Back Better bill is being contested by Republican members of Congress, and it appears Democrats will need all their Senate members, along with Vice President Kamala Harris’ vote, to make the bill into law. However, at least one Democratic Senator, Joe Manchin (D-WV), has already voiced his opposition to the bill, citing the impact of such spending on inflation and the deficit.