The Politics of OTC Hearing Aids

Many people with hearing loss, and many professionals involved in hearing health care, either support or disagree with the Over the Counter Hearing Aid Act currently being considered by Congress. Their reasons have to do with their view of what’s best for people with hearing loss.

I’m a strong supporter, as readers know. I don’t think Medicare coverage will ever happen unless hearing aid prices down come down. I also realize that while Medicare may not cover OTC hearing aids for mild to moderate hearing loss, it might recognize more serious hearing loss requiring expensive hearing devices as the legitimate medical condition that it is. So those of us who have to pay $3000-$4000 for adequate hearing aids may at last get some relief from Medicare. (Cheaper hearing aids may also get Medicare coverage, of course.)

I also believe that OTC hearing aids will be a gateway device for that 85 percent of people with hearing loss who do not now treat their loss. Competition will help bring costs down. More widespread use will help reduce stigma.

The Hearing Loss Association of America supports this bill. AARP supports the bill. The American Academy of Audiology (AAA) is neutral, the Academy of Doctors of Audiology  (ADA) supports it.

So who opposes it? The American Speech-Language-Hearing Association (ASHA), a  group representing hearing-health care professionals. So does the Hearing Industries Association (HIA).

And so does the gun lobby.

Yes, you read that correctly. Hearing Health and Technology Matters has been following the opposition. The Gun Owners of America oppose the bill, HHTM reports. So does Frontiers of Freedom, a non-profit conservative group based in Washington, DC. The opposition seems to stem primarily from the fact that one of the sponsors of the nonpartisan bill is Elizabeth Warren. The gun lobby says it fears it will restrict gun-owners’ rights.

Some Republican Congress members have resisted the conservative onslaught and recognize the value of the bill to their constituents. One of these is Congressman Vern Buchanan, who has represented Florida’s 16th district since 2013,  a district that holds the fourth-highest population of seniors aged 65 and older of any congressional district in the US.:  You can read HHTM’s article here: Florida Congressman the Latest to Co-Sponsor OTC Legislation, Despite Negative Ad Campaign Targeting GOP Supporters.

Republican co-sponsor of the bill, Chuck Grassley, of Iowa, tried to allay gun owners’ fears, stating  that “The Food and Drug Administration has made clear the bill wouldn’t compromise personal sound amplifiers that hunters use. However, language will be drafted to make clear that such devices are not affected just to be safe.”

So tell the gun lobby to mind its own business. The hearing health of millions of Americans is not part of it.

** For more on hearing health and hearing loss see “Shouting Won’t Help: Why I and 50 Million Other Americans Can’t Hear You.” and “Living Better With Hearing Loss,” both available on



14 thoughts on “The Politics of OTC Hearing Aids

  1. Katherine,
    Thanks for the continued updates on this important issue.
    In my opinion, this bill does not nearly go far enough, but it’s a good first step.

    Regulation is a particularly snarky endeavor. I believe that ALL regulation has to be done for a specific measurable benefit o consumers or citizens. To your knowledge, has this EVER been evaluated in the hearing aid? I’m referring, of course, to the current established and incredibly extensive occupational licensing laws regarding audiology, hearing aid dispensing, manufacturing of hearing devices and distribution/sales of such devices. This new bill simply challenges one tiny aspect of these regulations, but it’s a challenge that should be part and parcel of every regulation in this industry (and in all industries!).

    Compare, for example, the HA industry to the cell phone industry. I can get a used 2-year-old, fully featured smart phone, an incredibly complex device, for under $50, and shipped to me in 24 hours. That’s because this industry is largely unregulated. You don’t need a special license and years of training to sell these things. You don’t need FDA approval (after years long wait and millions of bucks) . Yes, you can buy hearing aids on the internet and discounts, but it is a murky, grey market, that feels like it’s about to be shut down by some FDA goon at any moment, arresting all its customers as well in the process.

    The freer the market, the better off the consumer.


  2. OTC Hearing Aids are fine for those with mild hearing loss. I am an advocate for hearing aids with telecoils and a program that lowers background noises in restaurants and airplanes and a manual volume control. OTC hearing aids may not have telecoils for hearing aid compatible telephones. I always wanted to hear and it was the Hearing Loss Association of America (HLAA) that gave me the education and information about hearing aids and hearing loss.


  3. The Gun Lobby? Next they will tell us what to eat! I asked Congress man Nadler and Senator Schumer to support the bills.




  4. The gun lobby uses hearing health when it wants to. The NRA is pushing an end to the limitations on silencers by arguing that silencers save hearing for shooters. Of course, silencers could also make it a lot harder for people to know they’re being shot at, or from where, but in the NRA’s view, that’s a small price to pay.


  5. The OTC effort to reduce hearing aid cost on the assumption that it will raise the percentage of adoption by hearing impaired has some curious curves to navigate. The consensus adoption rate in the U.S. seems to be something around 33%. Almost all of the hearing aid purchases are paid for by the consumer. In France, Germany and England where their governments pay for almost the total cost of hearing aids, the adoption rate is roughly 30%, 32% and 38%, respectively. So is cost really the barrier that we think it is? With our product VANISH, (, customers consistently emphasize how much stigma played a part in their reluctance to buy hearing aids. They appreciate a product that makes the tube less noticeable. Stigma is difficult to understand, but you can’t ignore it. I am in favor of anything that will bring hearing assistance to anyone who needs it, and I am glad to see both cost and stigma addressed as conditions that might need improvement.


    • Based on this excerpt from an article this year on hearing aids in France, your info may not be that accurate (see the last line):

      Several million people in France have hearing loss. However, of the 4.4 million people who could use hearing aids, only 1.5 million have these devices, a fitting rate of just 32% compared to 41% in the UK. One of the reasons commonly mentioned to explain these levels is the price of hearing aids. The cost of a hearing aid is on average about EUR 1,550 per ear, in other words EUR 3,100 for binaural fitting, which is generally the case. This price includes purchase and patient follow-up for the next five years. This amount could be an obstacle to consumers, especially seeing that coverage by the public healthcare system and top-up health insurance remains low in France: patients must pay about EUR 1,100 per ear, on average.

      I haven’t checked on Germany or England, but my guess is something comparable to France. It’s not just cost to be sure, it’s also ease of access. OTC aids will dramatically improve the availability of aids. Just like you can get a cell phone on every other street in most major cities. Okay, so the OTC aids may not be perfect for everyone, but if satisfies 80% of any person’s hearing loss, we’ve made great strides.

      There are three innovative CIC products that, if sold OTC, would improve the situation substantially (raise the percentages): Eargo (they do not do require any programming); Phonak Lyric (which are hard to insert, but I think with a little training can be done by the patient); Phonak Silk Primax. New materials for casing in these CIC aids obviate the need for custom molds. CIC’s eliminate all the stigmas associated with aids. Now we just have to get the cost down by selling these things WITHOUT the need for audiologists (ie, OTC). We’ll see incredible competition and more innovations and copycat products from China and India once the audiologist cartel is fully abolished. Eargo is already selling their aids OTC (actually through the web), and while they’re not for severe hearing loss, they are a fantastic product and CHEAP ($2000 for a pair, which includes a nifty recharging station).


  6. Over the counter hearing aids may turn a person off forever on using hearing aids. The price of hearing aids increases as people turn to tiny hearings that are completely in the canal CIC. In 1959 my landlord wore hearing aids that did not work because she told me that people would automatically speak louder when they saw them.


  7. This bill is one solution to a large problem in hearing healthcare. There is no doubt that the high cost of hearing aids has discouraged some people from getting the help they need. This is not to say that hearing care professionals do not bring value to the process, because they do. In addition to more choice, we believe there also should be more transparency in the industry. OTC hearing aids will provide more transparency and choice for potential hearing aids wearers. Right now, many of the consumers are in the dark about who manufacturers different brands, available pricing options and the financial ties many local practices have to particular manufacturers. Thank you for fighting for what is right!


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