Lodi mother Caprice Shular is hopeful that Assembly Bill 598, known as the Let California Kids Hear Act, will receive Gov. Gavin Newsom’s signature when it reaches his desk next week.

If signed, the bill will expand health insurance coverage to include hearing aids for children, which are not currently covered by health insurance providers.

When the Affordable Care Act was passed in 2010, it determined what medical equipment was considered necessary, but did not list hearing aids, allowing insurers to omit them from covered benefits, according to Mary Ellen Grant, the vice president of communications for the California Association of Health.

While the ACA is a federal mandate, the state can include its own requirements for health insurance coverage, which is what Assemblyman Richard Bloom, D-Santa Monica, set out to do when he authored the bill.

“Thousands of families are forced to pay the full cost of hearing aids, which cost, on average, between $3,000 and $8,000 per pair. Hearing aids are replaced frequently on growing children (a new replacement every three to five years), causing the cost of these devices to spiral over even a few years,” Bloom said in a statement.

After giving birth, Shular learned her daughter Avery was born with a hearing impairment.

Since 2006, children in California receive a hearing status screening at birth.

“Avery did not pass. Four weeks later, she did an in-depth test and we found out she had hearing loss, and we were devastated by the news,” Shular said.

She and her husband were overwhelmed when they learned that it would cost them $4,000 for Avery’s hearing aids, she said.

“We though our insurance would cover it, but they only covered $1,000,” Shular said.

The couple resorted to using a credit card to buy Avery’s hearing aids, and her ear molds — the piece that goes inside the ear — which cost $180.

“We were buying molds every two months because Avery got the hearing aids when she was a newborn,” Shular said. “When I tell people that my daughter’s hearing aids are not covered under any insurance provider, it blows their mind.” 

Children from families who earn less than $40,000 per year or who are enrolled in Medi-Cal receive free hearing aids through California Child Services. However, financial relief is not offered to children from middle-class families, according to Bloom.

“For many other families, lack of insurance coverage may mean they have to postpone their child’s hearing aid maintenance, fittings, adjustments, or audiologist visits,” he said.

Shular and her family have been following AB 598, and have attended meetings at the state Capitol, where they met Bloom.

Shular hopes the bill will pass because she worries how the cost of hearing aids will affect Avery as she grows older.

“Hearing aids are the most important thing to my daughter. It’s the first thing she asks for when she gets out of bed in the morning,” Shular said. “Because of her hearing aids, she can attend a regular school. Without them, she would have to attend a specialized school.”

Michelle Christie, who founded No Limits, a nonprofit organization that teaches school-age children with hearing loss how to thrive in an academic environment, is also advocating for AB 598. Through research she has conducted at the University of Southern California, she found that newborns with hearing impairments who get hearing aids before they are 6 months old grow auditory neural pathways and develop academically at the same rate as hearing children.

“AB 598 is not just about health equity, it is also about education equity and making sure that deaf and hard-of-hearing children have all the tools they need to live healthy and productive lives,” Bloom said.

On Monday, the bill passed the Assembly with unanimous consent — which is making insurance providers a little uneasy, according to Grant.

“We are not disputing the bill’s importance. It is the cumulative cost that has insurance companies distressed. Mandate benefits will increases premiums for all Californians,” she said.

Analysts with the California Health Benefits Review Program estimate that AB 598 will shift the funding burden to health plans and insurers, which will force copays and out-of-pocket maximums to increase across the board.

“We are struggling to strike a balance that keeps costs affordable, but every mandate that gets handed down from the legislature has a cost associated with it,” Grant said.

If Newsom signs AB 598 into law, California will become the 25th state to mandate that private health insurance companies cover the costs of hearing aids for children.

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