Objective: The purpose of this study is to understand variation across states’ private insurance mandates for hearing aids and to quantify yearly averages of the share of privately insured beneficiaries.

Methods: A team of audiology, public health law, and health policy experts and graduate students collected and coded state statutes mandating private insurance hearing aid coverage through January 1, 2023, using legal epidemiology. This data was combined with individual-level demographic variables from American Community Survey and Medical Expenditure Panel Survey [MEPS] Insurance Component data to estimate share of privately-insured youth <18 and adults <65 years of age covered by a hearing aid mandate from 2008 to 2022.

Findings: 25 states and 1 territory have private insurance hearing aid coverage mandates, varying in eligible age, frequency of benefit use, and total coverage amount. Between 2008 and 2022, the percent of privately-insured youth <18 years of age with mandated coverage increased approximately five-fold, from 2% to 11%. Less than 10% of privately-insured adults <65 years of age live in a state with coverage.

Summary: Hearing aid mandates cover a small but growing share of Americans. A federal mandate would expedite access, but, in the meantime, states can improve access by adopting mandates, expanding coverage, and removing barriers.