Legislative Counsel to the Hearing Industries Association
Financial assistance may be on the way for millions of older Americans and children who have untreated hearing loss. For those who cannot afford the cost of hearing aids, a bill introduced by Rep. Jim Ryun of Kansas, in September of 2003, may increase access to hearing aids through special tax treatment. Sen. Norm Coleman of Minnesota recently introduced the identical bill in the Senate. This means the hearing health community now has a bill pending before both Houses of Congress that would directly benefit children and older Americans who need hearing aids, but cannot afford them, through a tax credit. These bills represent a significant improvement over previous versions, as the scope of the benefit and the target audience has been widened to enable more individuals to be eligible for the benefit.
This article will address key issues relative to the Hearing Aid Assistance Tax Credit Act (numbered in the House and Senate as H.R. 3103 and S. 2055, respectively), including; The demographics of Hearing Loss in the USA, the tangible impact the bill would have on individuals with hearing loss, why the bill is important to everyone concerned with hearing health, and, what steps can be taken to maximize the chance this bill will be enacted into law.
Hearing loss in America: A Growing Demographic Issue
With publication of the landmark 1999 study funded by the Hearing Industries Association (HIA) and conducted by the National Council on Aging (NCOA), Americans became acutely aware of the negative repercussions of untreated hearing loss on a persons personal, emotional and psychosocial quality of life. The study concluded that untreated hearing loss most commonly results in depression, withdrawal from social situations, social isolation, impaired memory, and reduced overall health. Yet, these same harmful psychological factors are eliminated or greatly reduced once patients are treated with hearing aids; furthermore, the emotional and social well being of patients who use hearing aids are sustained over time.
Last year, an article in the Journal of the American Medical Association (JAMA) concluded that older adults can be screened for hearing loss using simple methods, and that effective treatments, including hearing aids, exist for many forms of hearing loss common to the elderly. Despite the fact that hearing loss is the third most prevalent chronic condition in older Americans, the study noted that older patients are simply not being screened or treated for hearing loss.
These studies and others point to a growing awareness in the medical and research community that hearing loss for older Americans is not simply a normal part of growing old, and in fact, is not a benign health condition at all. Furthermore, hearing loss in people of all ages can usually be successfully treated, and well over 90% of these individuals can be treated with hearing aids.
Yet, for 28 million Americans at all stages of life who have some degree of hearing loss, only 22% (6.3 million) use hearing aids now. Included in the 28 million, are approximately 1 million children under the age of 18 who are not currently being treated for their hearing loss, as well as some 10 million Americans age 55 and over. According to a recent MarkeTrak report (the largest national consumer survey on hearing loss in America), 30% of those with hearing loss cite financial constraints as a core reason they do not use hearing aids. Further compounding this overall grim financial picture is the fact that workers with untreated hearing loss receive far less in wages then their non-hearing impaired colleagues, thereby further exacerbating the ability of many people to purchase hearing aids out-of-pocket. Financial constraints become a bigger issue when one considers that hearing aids are not covered by the vast majority of state-mandated health benefits, or Medicare.
When the financial and societal implications of untreated hearing loss are viewed through the prism of Americas Baby Boomer population, where incidences of hearing loss rise dramatically with age, it becomes apparent that legislation is urgently needed to help more people gain access to hearing aids as an effective form of treatment.
S. 2055/H.R. 3103: a practical step forward to address hearing loss
The Hearing Aid Assistance Tax Credit Act would provide a $500 tax credit per hearing aid purchased for individuals age 55 and over, and for those purchasing hearing aids for a dependent. Thus, an individual who needs two devices would be subject to a $1,000 tax credit; likewise, a parent and child, or husband and wife, would also be eligible to receive the same benefit. The tax credit would not be refundable and could be used once every five years. There are no restrictions on which type of hearing aid may be purchased, as long as the device is considered a qualified hearing aid under federal law, and consumers would be able to purchase devices from a provider of their choice.
By contrast, previous legislative attempts at addressing hearing loss through the tax code provided only $500 as the maximum benefit, and only for those over age 65. To address the problems in the earlier bills, the Hearing Industries Association (HIA), the national non-profit trade association for hearing aid manufacturers, and Self Help for Hard of Hearing People (SHHH), a national consumer organization for individuals with hearing loss, worked with Rep. Ryun, and later with Sen. Coleman, to craft a new proposal which is more responsive to the needs of a greater segment of the population. As explained later in this article, the two new bills have been endorsed by virtually every hearing health organization.
One question which has been asked since introduction of the new bills is: why didnt we seek a non-age specific tax credit? Put simply, we advocated for the most generous bill possible that also from a federal budgetary standpoint - has a reasonable chance of passing Congress in the next few years.
Why are budget constraints relevant to this bill? In a political climate of rapidly rising health costs, large budget deficits, and a shrinking pool of federal revenues to support any new spending initiative, no matter how worthy, the chances for passing a comprehensive bill are dim. With that in mind, we believe it is preferable, as a first step, to try to address the problem of untreated hearing loss incrementally through a more targeted approach. For these reasons, the bill is structured to provide a measure of financial relief to the two population segments who are most likely to be unable to afford the full cost of hearing aids: the elderly or those approaching retirement, and families with children.
Since the introduction of the Hearing Aid Assistance Tax Credit Act, the number of national organizations endorsing this initiative has continued to grow, as has the scope of grassroots outreach and constituent input from individuals across the country. Virtually all major hearing health organizations, including the American Academy of Audiology, American Speech Language Hearing Association, Deaf and Hard of Hearing Alliance, Deafness Research Foundation, International Hearing Society, among others, as well as HIA and SHHH, have played instrumental roles in directly lobbying Congress to educate Members in the House and Senate on the merits of the bill, and to elevate general public awareness about hearing loss.
Getting involved: How You Can Support This Effort
As a result of these combined efforts, support for the legislation has grown substantially over the last few months. At the same time, it is important to note that over 6,000 different bills have been introduced in this Congress to date, only a very small fraction of which will actually be signed into law. For this reason, gaining the requisite support needed in order for Congress to pass the Hearing Aid Assistance Tax Credit Act is almost always a multi-year process.
What distinguishes bills that become law from the vast majority that fall by the wayside, is due in large part to the amount of local constituent support that can be demonstrated on a nationwide basis. Members of Congress need to understand the depth of support that exists on a particular issue back home before deciding to take action to lend their support.
On behalf of the organizations that have endorsed this worthwhile effort, we urge all Audiology Online (www.audiologyonline.com) and Healthy Hearing (www.healthyhearing.com) readers to take the time to send a letter of support for H.R. 3103 and S. 2055 to their Representative and Senators. Sample letters are available on various organizations websites (see www.hearing.org; or www.starkey.com, as examples) or individual writers can draft their own.
I also encourage readers to take the time to call their congressional offices and express support for the bills, preferably to the staff member who handles health legislative issues.
Lastly, never underestimate the benefits of developing a positive relationship with ones own Member of Congress, by meeting with him or her directly, volunteering to help with their campaign effort, and similar outreach activities.
In closing, the Hearing Aid Assistance Tax Credit Act is arguably among the most important initiatives related directly to increasing access to treatment for hearing loss in recent years. Not only will it enable more people to utilize the benefits of hearing aids to treat their hearing loss, but it also elevates public awareness of hearing health and the need to treat hearing loss effectively. That message helps all Americans who may one day may face the prospect of dealing with hearing loss, for themselves or a family member.
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Deborah Outlaw is an attorney and principal in a health care consulting firm, providing legislative, regulatory and medical coding services to physician specialty groups, allied health providers, and device manufacturers. She has over 20 years of experience in developing health care and public policy in Washington, D.C., having worked on Capitol Hill for a U.S. Senator, and in two Presidential Administrations.
Ms. Outlaw can be contacted via:
Legislative Counsel to the Hearing Industries Association