HOUSE BILL REPORT

2SSB 5179

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

As Reported by House Committee On:

Health Care & Wellness

Title: An act relating to requiring coverage for hearing instruments under public employee and medicaid programs.

Brief Description: Requiring coverage for hearing instruments under public employee and medicaid programs.

Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Bailey, Keiser, Palumbo, Hasegawa and Conway).

Brief History:

Committee Activity:

Health Care & Wellness: 3/21/17, 3/22/17 [DPA].

Brief Summary of Second Substitute Bill

(As Amended by Committee)

  • Requires coverage for hearing instruments for enrollees in Medicaid and Public Employees' Benefit Board health plans.

HOUSE COMMITTEE ON HEALTH CARE & WELLNESS

Majority Report: Do pass as amended. Signed by 15 members: Representatives Cody, Chair; Macri, Vice Chair; Caldier, Clibborn, DeBolt, Harris, Jinkins, MacEwen, Maycumber, Riccelli, Robinson, Rodne, Slatter, Stonier and Tharinger.

Minority Report: Do not pass. Signed by 2 members: Representatives Schmick, Ranking Minority Member; Graves, Assistant Ranking Minority Member.

Staff: Chris Blake (786-7392).

Background:

The Health Care Authority (Authority) has responsibility for a number of health care programs for public employees and low-income residents of Washington.

Hearing Aid Coverage for Public Employees' Benefits Board Plan Enrollees.

The Public Employees' Benefits Board, acting through the Authority, approves benefit plans and premiums for active state employees, retired state and K-12 employees, and some active local government and K-12 employees. Under the Uniform Medical Plan, enrollees may receive one hearing examination every year. Enrollees may receive up to $800 every three years for the purchase of a hearing aid, ear molds, batteries and cords, and a follow-up consultation.

Hearing Aid Coverage for Medicaid Enrollees.

The Health Care Authority administers the Medicaid program which is a state-federal program that pays for health care for low-income state residents who meet certain eligibility criteria. Benefits under the program vary according to a person's eligibility category which is determined by several factors, including income, age, health condition, and disability status.

Hearing aid coverage is currently available for Medicaid clients who are 20 years old and younger once they have completed a hearing evaluation and received a referral for a hearing aid. In addition, adults who are enrolled for coverage through the Developmental Disability Administration at the Department of Social and Health Services may receive hearing aids. Coverage includes new monaural or binaural hearing aids, as well as ear molds, replacement parts, and repairs. Hearing aid coverage had been available for adults enrolled in Medicaid until the 2011-13 Operating Budget eliminated the benefit.

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Summary of Amended Bill:

Beginning January 1, 2018, health plans offered to public employees and their dependents must include coverage for no more than one new hearing instrument every five years and services and supplies such as the initial assessment, fitting, adjustment, and auditory training.  The hearing instrument must be recommended and dispensed by an audiologist or hearing aid specialist.

Beginning January 1, 2018, medical assistance programs must include coverage for hearing instruments when medically necessary.  The coverage must include no more than one new hearing instrument every five years and services and supplies such as the initial assessment, fitting, adjustment, and auditory training.  The coverage must provide a new hearing instrument sooner than five years if alterations to an enrollee's existing hearing instrument does not meet the client's needs.  The hearing instrument must be recommended and dispensed by an audiologist or hearing aid specialist.

The term "hearing instrument" is defined as any wearable prosthetic instrument or device that aids, improves, compensates for, or corrects defective human hearing.  The term includes any parts and accessories, except for batteries, cords, ear molds, and assistive listening devices.

The Medicaid benefit is null and void if it is not referenced in the operating budget.

Amended Bill Compared to Second Substitute Bill:

The amended bill specifies that coverage for hearing instruments for Public Employees' Benefit Board enrollees and Medicaid enrollees is limited to no more than one hearing instrument every five years.  An exception to the five-year limitation is established for Medicaid enrollees whose existing hearing instrument cannot be altered to meet their needs.

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Appropriation: None.

Fiscal Note: Available.

Effective Date of Amended Bill: The bill takes effect 90 days after adjournment of the session in which the bill is passed. However, the bill is null and void unless funded in the budget.

Staff Summary of Public Testimony:

(In support) Many people in long-term care settings cannot hear and do not have the luxury of a hearing aid.  If someone cannot hear and cannot afford a hearing aid, the state needs to assure that the person can obtain one, otherwise it may cost the state a lot more later.  The cost of hearing aids is prohibitive for many families, especially people on Medicaid.  Some people must get loans to afford hearing aids, but that is not an option for people on Medicaid.

Providing hearing aid coverage under Medicaid will significantly improve the health and well-being of many older Washingtonians.  Two-thirds of people over 65 years old will suffer from hearing loss.  Hearing aids help assure that people understand instructions from their doctors and caregivers so they can stay healthy and independent. Hearing aids can protect against social isolation.  Persons with untreated hearing loss are more likely to report depression and anxiety and are less likely to participate in social activities compared to those with hearing aids.  Statistics show that once someone can no longer hear, most of the time they will lose cognitive ability, slip into dementia, and maybe even develop Alzheimer's disease.  Hearing aids help people be productive.

(Opposed) None.

Persons Testifying: Senator Bailey, prime sponsor; Joanna Grist, AARP; and Cynthia Stewart, Hearing Loss Association of America.

Persons Signed In To Testify But Not Testifying: None.