Michelle Marciniak, Co-Chair, Let California Kids Hear
Testimony in in Senate Budget Health Committee on Hearing Aid Coverage for Children Program (HACCP) Implementation Issues AND revisiting a solution
APRIL 20, 2023
Hello my name is Michelle Marciniak, I am Co Chair and Co- Founder of Let California Kids Hear, and this is my daughter, who has been advocating for children’s access to hearing aids in CA since 1st grade.
We would like to thank the Chair, the Committee, leadership in both chambers, Senator Portantino and Assemblymember Dr. Arambula for continuing to stand with our children in this multi-year effort.
In 1998, California passed a mandate for Newborn Hearing Screening acknowledging the urgent need to screen, diagnose and provide intervention for deaf and hard of hearing children. Yet today access to hearing aid for children is not mandated, despite multiple efforts over the past 25 years. Dr. Carvalho at Rady’s Children’s testified “California does a beautiful job in screening and identifying our children with hearing loss, but fails miserably when it comes to treating them”.
In 2019, AB-598, the Let California Kids Hear Act, a bill that would mandate health plans to cover hearing aids and services for children received unanimous support in the legislature. As an alternative to the bill, the Newsom Administration offered the Hearing Aid Coverage for Children Program (HACCP) supporting families with incomes up to 600 FPL. Since the program began on July 1, 2021, it has received an annual budget of over $6 million to administer and $10 million for benefits. Two months shy of the 2-year anniversary, with $32.8M in total funding, less than 200 of the 7,000 children have received hearing aids through the program.
Despite significant implementation issues that impeded utilization in the first 22 months, DHCS is now valuing the program at $1.6M, an 83% reduction, while maintaining $6.1M to administer. Our biggest concern is the program is not recession proof for some of the most vulnerable children whereas a mandate is. Additionally, few pediatric providers are participating due to historically low reimbursement rates; creating poor geographic coverage, segmented care, and barriers that are difficult to overcome. California is not alone in these challenges as Georgia tried a similar program and failed, ultimately passing a mandate in 2018.
Assemblymember Dr Arambula said at the Asm Budget SubCommittee hearing last month “I would like my legislative colleagues and the Administration to have an honest conversation about whether it’s time to reopen the discussion about a requirement for commercial plans.”
The Let California Kids Hear Act is better positioned with significant momentum across this country with recent federal and state action taken since. The Biden Administration and HHS Secretary have demonstrated a strong commitment to help hard of hearing adults with Over the Counter (OTC) hearing aids and there are efforts to cover seniors at the federal level. This has opened the door for children. In 2024, over 30 states will require support for pediatric hearing aids through a state requirement and/or the inclusion in the State’s Essential Health Benefits benchmark selection. In fact, nine states passed
mandates after the 2012 ACA provisions went into effect, and another five states are considering requirements during the 2023 legislative cycle. California is not one of them.
Today, our coalition is asking you to revisit the Let California Kids Hear Act with modifications that address the Administration’s previous concerns. The bill would reduce barriers to time sensitive care and provide the treatment needed for the 8,000 + California families currently without coverage for their child’s hearing aids that the HACCP has been unable to successfully serve to date.
This requirement would allow families to use their commercial plans supporting access to local providers within their medical homes, reducing delays, and improving outcomes for kids. For example, currently families in the program have trouble finding providers. There are no providers in Sacramento and Central Coast; only one center in Central Valley and the first major pediatric center in Los Angeles, only came online mid-January. Kaiser, which covers more than 50% of the commercially insured in California, does not currently participate in the HACCP.
A mandate would significantly reduce and possibly in the future eliminate the need for the program that had an annual budget this fiscal year of $16.1M. The program could be scaled down to serve the children on self-insured plans for which the mandate would not apply.
Given the fundamental challenges with the program and significantly greater cost, the best solution to support the timely treatment of pediatric hearing loss is through an insurance requirement.
Inclusion of the Let California Kids Hear Act in the 2023/2024 budget would significantly reduce the current spending by an estimated $10 M per year, and put in place a permanent, recession-proof solution to protect some of California’s most vulnerable children.
Local UCSF expert physician Dr. Chan testified in the Senate ”Pediatric hearing loss is considered a developmental emergency requiring timely intervention to prevent permanent delays. These preventable consequences are not only devastating for the child and family; they are costly to society.“
LCKH Junior Ambassador: However, research shows that children aided by three to six months of age can develop at the same rate as their hearing peers. Please Let California Kids Hear and help us get this across the finish line. Thank you for caring about our future.