By a 5 to 4 decision, the Supreme Court of the United States has upheld most of the provisions in the Affordable Care Act, otherwise known as “Obamacare.” In the short term, the decision has little effect on the hearing health industry, although more insured people will be eligible for hearing exams and ENT services in 2014.
The court upheld the most contentious individual mandate provision, which requires those without health insurance to pay a fine, starting in 2014. The court held that the penalty is essentially a tax, and Congress has complete authority to levy taxes that affect all states.
The only part of the law struck down was the portion that would restrict a state from receiving all of its federal Medicare funds if the state chose not to expand Medicare coverage to more middle class households, another new provision in the law. As a result, states now can receive the extra subsidy provided to them under the Affordable Care Act for expanding Medicare, but they are not required to use the extra funds to expand coverage to more low income and middle class families. As written, the subsidy is not enough to cover the new people eligible in 2014, falling about 10% short in the case of some states.
Other provisions under the law remain solidly intact. These include requiring states to establish health insurance exchanges, preventing insurers from denying coverage to those with preexisting conditions, and allowing children to remain on a parent’s insurance plan until the age of 26.
As for the effect on the hearing industry, there is currently no Federal coverage for hearing aids under Medicare, Medicaid, or a mandate that insurers provide coverage for hearing aids. However, by having more people insured via the various mandates or coverage expansions, audiologists and ENTs may see an increase in patients seeking hearing health diagnostic care.
In addition, cochlear implants are generally covered by insurance and Medicare, so it is possible that newly insured individuals will seek a cochlear implant assessment and treatment.
The Hearing Industry Association also released a statement, saying that the decision will not significantly affect manufacturers at this time.
Hearing Review will continue to report any updates to the Affordable Care Act that affect the hearing health industry.