The Capitol dome against a yellow sunset

Policy & Legislation

The Cochlear Center generates and amplifies science-based evidence that supports Medicare reforms to make hearing care coverage available and hearing aids more accessible and affordable. 

Cochlear Center faculty were instrumental in two of the biggest developments in U.S. hearing care policy in decades:

  • The FDA’s final regulations for over-the-counter hearing aids
  • The inclusion of hearing care in the Biden Administration’s “Build Back Better” legislation. The final bill for the Build Back Better Act, passed out of the House of Representatives in late 2021, specifically included nearly $35 billion in funding for the coverage of hearing aids and hearing care services under Medicare. This was the first time that explicit federal funding has been proposed for hearing coverage since the inception of Medicare in 1965. While the Build Back Better Act stalled in the U.S. Senate, we are optimistic that with the framework of this Medicare hearing benefit now in place, this effort will be resurrected in future sessions of Congress.

The Path to OTC Hearing Aids and Toward Improving Medicare Coverage of Hearing Care

2014

Frank Lin initiates and chairs a National Academies of Sciences, Engineering, and Medicine workshop on hearing loss and healthy aging, where the topic of federal regulations for OTC hearing aids is first discussed at a forum with national policymakers and stakeholders.

2015President Barack Obama leads discussion around a conference table

Frank Lin and Nicholas Reed advise the White House President’s Council of Advisors on Science and Technology on their report that recommends OTC hearing aid regulations.

2016 

Frank Lin is a member of the NASEM consensus study on Accessible and Affordable Hearing Care for Adults recommending OTC hearing aid regulations.

2017 Frank Lin testifying to Congress 2017

Frank Lin testifies before the United States House of Representatives in support of the Over-the-Counter Hearing Aid Act. The Over-the-Counter Hearing Aid Act passes with bipartisan support as part of the FDA Reauthorization Act of 2017 and requires the Food and Drug Administration to create a regulatory classification for over-the-counter hearing aids, which will dramatically alter access to and the cost of hearing technologies in this country.

2019

Cochlear Center faculty Amber Willink, PhD was asked to draft a memo for the House of Representatives about coverage options for a Medicare hearing benefit. This language is pulled directly into the Medicare Hearing Act of 2019 (H.R. 4618), which was later incorporated into the broader Lower Drug Costs Now Act (H.R. 3) and passed by the House of Representatives in December 2019. This bill does not pass the Senate. 

2020

Cochlear Center shares high-level policy briefs illustrating the gaps and opportunities in Medicare coverage of hearing care and hearing aids with legislative directors and health policy advisors for Senators and Representatives; budget analysts at the Congressional Budget Office; NASEM; others.

2021Comic book-style illustration of a woman asking "What Do You Mean Medicare Doesn't Cover Hearing Aids?"

The Cochlear Center shares a "graphic narrative" with legislative directors and health policy advisors for Senators and Representatives, budget analysts at the Congressional Budget Office, and more broadly via non-profit partners. This attention-grabbing and approachable format illustrates the challenges Medicare beneficiaries face trying to get hearing care services and hearing aids. It was subsequently published in the Annals of Internal Medicine. 

STAT News Op-Ed image

Earned media coverage takes the message more broadly: two Op-Eds by Frank Lin and collaborators (STAT News: Making hearing aids affordable isn’t enough. Older adults also need hearing care services, and Health Affairs Blog: Dementia Policy is a National Priority. That's Why Congress Needs to Expand Medicare to Cover Hearing Aids) and a piece by Jane Brody for the New York Times, “Will Hearing Aids Ever Be Hip?”

The Food & Drug Administration releases draft guidelines for over-the-counter hearing aids. Logo of the Food & Drug Administration

Center Director Frank Lin and Associate Faculty Marilyn Albert, PhD served on the workgroup for the National Alzheimer’s Project Act that developed recommendations to address modifiable risk factors for dementia: Action 6.B.2 of the updated National Plan to Address Alzheimer’s Disease, specifically calls for increasing access to hearing aids to reduce dementia risk.

Build Back Better budget line itemsLanguage from H.R. 3 serves as the basis for the Biden Administration’s $1.75T Build Back Better Framework to fund coverage of hearing aids and hearing care services under Medicare, the first time that explicit federal funding has been proposed for hearing coverage since the inception of Medicare in 1965. 

The final bill for the Build Back Better Act, passed out of the House of Representatives in late 2021, specifically included nearly $35 billion in funding for the coverage of hearing aids and hearing care services under Medicare. This was the first time that explicit federal funding has been proposed for hearing coverage since the inception of Medicare in 1965.

While the Build Back Better Act stalled in the U.S. Senate, we are optimistic that with the framework of this Medicare hearing benefit now in place, this effort will be resurrected in future sessions of Congress.

2022  

The FDA’s final guidelines for over-the-counter hearing aids open a new market for consumer hearing technology.

2023 

The ACHIEVE study main findings, published in the Lancet in July, showed that in older adults at increased risk for cognitive decline, hearing intervention slowed down loss of thinking and memory abilities by 48% over 3 years.  Treating hearing loss may be a particularly important public health target for dementia prevention efforts. Hearing loss is modifiable risk factor for dementia that could be addressed at scale to help reduce the risk of dementia and the cognitive decline that precedes dementia onset. 

Policy changes are needed in the U.S. to increase affordable access and insurance coverage for hearing aids and related hearing technologies, and the diagnostic and hearing care support services of an audiologist to guide the individual in using these hearing technologies to hear and communicate optimally.