Ally’s Act
Summary
The "Ally's Act" (H.R. 4606) mandates that private health insurance plans cover hearing devices and systems for qualifying individuals. This includes auditory implants, maintenance, upgrades, and related services like assessments, surgery, and rehabilitation. The bill amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974, the Internal Revenue Code of 1986, and the Patient Protection and Affordable Care Act to enforce this coverage.
The Act aims to ensure that financial and treatment limitations for hearing devices are no more restrictive than those for other medical and surgical benefits. It also prohibits denial of coverage when a physician or audiologist deems the devices medically necessary. The amendments will apply to plan years beginning on or after January 1, 2026.
Expected Effects
The Ally's Act will expand access to hearing devices and related services for individuals with hearing loss who have private health insurance. This will likely increase the number of people receiving necessary treatment and improve their quality of life. The bill also standardizes coverage requirements across different types of health plans.
Potential Benefits
- Improved access to hearing aids and implants for those with hearing loss.
- Reduced financial burden on individuals and families needing hearing devices.
- Enhanced quality of life through better hearing and communication.
- Standardized coverage requirements across various health insurance plans.
- Prevents insurance companies from denying coverage deemed medically necessary.
Potential Disadvantages
- Increased healthcare costs for insurance companies, potentially leading to higher premiums for all policyholders.
- Possible administrative burden for insurance companies to implement and manage the new coverage requirements.
- Potential for overuse or unnecessary procedures if medical necessity determinations are not carefully managed.
- The bill does not address hearing aid coverage for those without private insurance (e.g., those on Medicaid or without insurance).
- The definition of 'qualifying individual' could be interpreted narrowly, limiting access for some.
Most Disadvantaged Areas:
Constitutional Alignment
The Ally's Act appears to align with the general welfare clause of the US Constitution, as it aims to improve the health and well-being of individuals with hearing loss. While the Constitution does not explicitly address healthcare mandates, the Act falls within the broad scope of Congress's power to regulate interstate commerce and provide for the general welfare. The Act does not appear to infringe upon any specific constitutional rights or freedoms.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).