What is it about?
This study examined how Medicaid hearing aid coverage for adults changed across the United States from 2003 to 2023. Medicaid is a public health insurance program, but adult hearing aid benefits are optional and vary widely by state. The study focused on Medicaid fee-for-service programs, meaning traditional Medicaid programs in which the state pays providers directly for covered services, rather than coverage managed through a private health plan. To better understand changes over time, the authors created a longitudinal database of state Medicaid hearing aid coverage policies for adults over age 20. They used policy surveillance, a systematic way of collecting and coding laws and policies, and combined these policy data with American Community Survey data to estimate how many adult Medicaid beneficiaries lived in states with hearing aid coverage. The study found that 32 states offered adult Medicaid hearing aid coverage in 2003. This dropped to 27 states by 2013 and rose to 31 states by 2023.
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Why is it important?
Hearing aids can be an important part of care for adults with hearing loss, but they are often expensive and not consistently covered by insurance. This study shows that Medicaid hearing aid coverage for adults has changed over time and remains highly dependent on where a person lives. Even when national estimates suggest that about 70% of adult Medicaid beneficiaries live in states with coverage, that still leaves many adults without this benefit. It also means that access to hearing care may depend less on clinical need and more on state policy. For audiologists and other hearing health professionals, these findings highlight why insurance coverage must be part of conversations about access to care. A patient may be an appropriate hearing aid candidate, but coverage rules can shape whether hearing aids are realistic, affordable, or timely. For researchers and policymakers, the study provides a database that can be updated and used to evaluate policy change over time. This matters because improving hearing health care requires more than demonstrating that hearing treatment is beneficial. It also requires understanding whether people can obtain the care they need through existing systems.
Perspectives
“I see this work as part of a broader effort to make hearing health care more visible within health policy and public health. For many adults with hearing loss, the question is not simply if hearing aids will help. The question is whether the pathway to care is accessible and affordable. This study was important to me because Medicaid policy is often discussed as a yes-or-no issue, but the reality is more complicated. Coverage can change over time, vary across states, and differ in ways that are difficult for patients and clinicians to track. By building a longitudinal database, we wanted to create a clearer picture of how adult Medicaid hearing aid coverage has changed over two decades and how many beneficiaries may be affected by those policies. I hope readers take away that hearing health care access is shaped by policy, not only by individual motivation or clinical need. Audiologists often see the consequences of coverage gaps in practice, but those gaps also need to be measured systematically if we want to improve them. This paper does not answer every question about hearing aid use or outcomes, but it provides a foundation for asking better questions about coverage, affordability, and the role of public insurance in supporting hearing health across adulthood.” - Dr. Michelle Arnold, AuD, PhD, CCC-A
Lauren Tonti
University of Missouri Columbia
Read the Original
This page is a summary of: Longitudinal Trends in Medicaid Hearing Aid Coverage for Adults in the United States: 2003–2023, American Journal of Audiology, May 2026, American Speech-Language-Hearing Association (ASHA),
DOI: 10.1044/2026_aja-25-00204.
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