Nationwide Class Action Lawsuit Challenges Kaiser's Hearing Aid Coverage Policy

In a move that could reshape healthcare coverage for millions of Americans with hearing disabilities, Jason Delessert, a resident of Burien, Washington, has initiated a nationwide class action lawsuit against Kaiser Foundation Health Plan. The lawsuit challenges Kaiser's policy of excluding prescription hearing aids from health plan coverage, alleging that this practice constitutes illegal disability discrimination under the Affordable Care Act (ACA).

This legal action marks the first nationwide class action lawsuit to bring a disability discrimination claim under the ACA on behalf of hearing-disabled enrollees who require prescription hearing aids. The case builds upon a previous lawsuit, Schmitt v. Kaiser Foundation Health Plan of Washington, which addressed similar exclusions but was limited to Washington state insureds and settled without including Delessert.

Delessert, who relies on prescription hearing aids for daily communication, work, and social interaction, argues that Kaiser's refusal to cover these devices as 'durable medical equipment' under his health plan is discriminatory. He contends that hearing aids are as essential for individuals with hearing disabilities as wheelchairs are for those with mobility impairments.

Eleanor Hamburger of Sirianni Youtz Spoonemore Hamburger PLLC, one of Delessert's attorneys, asserts that Kaiser's exclusion of prescription hearing aids specifically targets people with hearing disabilities, which she claims is illegal discrimination. The lawsuit cites the ACA's requirement that health plans have an affirmative obligation not to discriminate in healthcare provision, particularly considering the needs of disabled individuals.

The legal challenge comes four years after the Schmitt court ruling, which highlighted the ACA's intent to prevent discrimination against disabled people in health insurance. Despite this ruling, Kaiser has continued to apply a categorical hearing aid exclusion in Delessert's health plan and many others across the country.

Anna Prakash of Nichols Kaster, another attorney representing Delessert, emphasizes that hearing aid exclusions stem from historical discrimination against disabled individuals by the health insurance industry. She argues that the ACA was designed to end such discriminatory practices, including those affecting enrollees with hearing disabilities.

This lawsuit has the potential to significantly impact healthcare access and insurance practices nationwide. If successful, it could compel Kaiser and potentially other health insurers to revise their coverage policies for hearing aids and other assistive devices. This could lead to improved healthcare access for millions of Americans with hearing disabilities, potentially reducing out-of-pocket expenses for essential medical equipment.

The case also raises broader questions about the interpretation and enforcement of the ACA's non-discrimination provisions. A favorable ruling for the plaintiffs could set a precedent for challenging other exclusions in health insurance policies that disproportionately affect individuals with specific disabilities.

As the lawsuit progresses, it will likely draw attention to the ongoing challenges faced by individuals with hearing disabilities in accessing necessary healthcare services and equipment. The outcome of this case could have far-reaching implications for how health insurers approach coverage for various disabilities and chronic conditions, potentially leading to more inclusive and comprehensive healthcare policies across the United States.