The Missouri House voted overwhelmingly Thursday to expand coverage for hearing aids and cochlear implants for adults enrolled in Medicaid.
The bill now heads to the Senate for consideration.
Currently, Medicaid in Missouri, which is called MO HealthNet, only covers hearing aids for eligible children, pregnant women and blind people. The bill, sponsored by Republican state Rep. Cameron Parker of Campbell, would expand coverage to all individuals on Medicaid. Medicaid is the federal health care program for low-income and disabled Americans, which is administered by the states.
“Hearing loss affects many, many people, including many of our own family members,” Parker said during House debate of the bill on Thursday. “The ability to hear and communicate is critical to a person’s independence, and the benefits of these services will affect many Missourians.”
In a press conference Thursday, Parker shared a story of a constituent with hearing loss who was unable to get her hearing aids repaired after she turned 18.
“She was working at the local McDonald’s, and she could not afford to get her hearing aids fixed. And so then she got fired from McDonald’s,” Parker said. “So she lost her independence. She lost her ability to support her family or help support her family.”
State Rep. Jo Doll, a St. Louis Democrat who sponsored similar legislation this year, said many members of the Missouri House benefit from hearing aids.
“And we know that those hearing aids provide an increased quality of life for the people that need them and have them. So I would encourage you to vote yes on this bill and make sure that everybody in Missouri can access the same devices that we have,” she said.
It was approved by the House by a vote of 148 to 8.
There was no opposition voiced in Thursday’s debate, but in previous years, there has been some concern around the cost. The eight in opposition Thursday were Republicans.
The fiscal note estimates that 15,915 Medicaid enrollees would seek out hearing aid services if the bill passes. Due to “pent-up demand,” the fiscal note states, many of those individuals may seek services in the first year they become available, which would be fiscal year 2026.
The fiscal note estimates a cost of up to $10.6 million that year, and up to $2.8 million in the following year. The majority of that would be in federal funding.
In the public hearing on the bill in January, Parker said: “I realize there are some costs to this, but I do believe that the benefit of these services, the hearing instruments, the cochlear implants, outweigh the cost greatly.”
Doll added that hearing aids may save the state money in the long run by helping reduce the risk of dementia and keeping individuals out of nursing homes.
Rep. Ann Kelley, a Republican from Lamar, said her husband has hearing issues and wouldn’t have succeeded professionally without hearing aids.
“I know this has got a massive fiscal note,” Kelley said, “and this is one of those instances where we have to think beyond the fiscal note, and how much it’s going to help.”
Last year, the bill was voted out of the House by a vote of 149 to 3, and passed a Senate committee but never came up for a vote in the Senate, which Doll said was due to the Senate’s dysfunction in the final days of session.
No one testified in opposition to the bill in the public hearing held in January.
Dr. Kate Sinks, director of audiology at the Center for Hearing and Speech in St. Louis, testified at the public hearing in January that 36 states already offer full coverage under Medicaid for hearing aids and cochlear implants for adults.
Sinks said that she has heard thousands of stories from patients about how hearing devices have “changed their lives, from going to the symphony, to getting their dream jobs, reconnecting with family, being able to run a simple errand independently, and even hearing the alarm when their home caught fire.”
Mallory Rusch from anti-poverty advocacy organization Empower Missouri told the committee the cost of a hearing aid ranges from $1,000 to $4,000. Yet an individual qualifying for Medicaid in Missouri makes no more than $21,597 per year. For a family of four, the annual income cap to qualify for Medicaid is just under $43,000.
“I would invite you to consider your own families’ annual income and expenses,” Rusch said, “and then consider if you feel like an individual or family earning that low of an income could manage to be able to afford a $2,500 medical bill on average, just to be able to hear.”
Christina Koehler, an audiologist, said it is “extremely heartbreaking” to see people age out of coverage. “And they do become less involved in society,” she added.
Dr. Kristen Lewis, audiologist at Midwest Ear Institute in Kansas City, said she sees patients without access to hearing aids or cochlear implants “face a vicious cycle of isolation, unemployment and diminished quality of life.
“By providing Medicaid coverage for these essential devices,” Lewis testified in January, “we not only support the well being of these individuals, but also help them remain productive and contributing members of society.”
