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



Advocacy: Lessons Learned

My friend and HLAA colleague Ruth Bernstein gave me permission to repost this excellent essay.

Posted by Ruth Bernstein on May 5, 2017

Sound Advice by Ruth D. Bernstein

I have a history as an advocate for people with hearing loss which goes back many years. In the process of advocating, I’ve learned many lessons, a few of which I want to share with you in recognition of Better Hearing and Speech Month.

Lesson One – Coping with hearing loss is a 24/7/365 business. It is an integral part of life. I’ve chosen to make advocacy one of the priorities in my life because I have been very lucky and had constructive, compassionate help from the professionals I’ve dealt with. I want to return that help and compassion to others. I also discovered along the way, I’m a bit of a ham and like sharing my ideas with an audience.

Lesson Two – Asking for what we need in detail, in writing and in advance is useful, e.g. asking for CART, an assistive listening system, a seat that gives a good view of the speakers or stage, a hotel room that is wired with alerting devices. These requests allow us to participate in activities we might not have been able to enjoy otherwise. They also encourage people with hearing loss who don’t know about these accommodations to learn about them.

Lesson Three – Explaining why we need accommodations educates the people we deal with. It puts a human face on the problems people with hearing loss encounter. I’m always pleased to hear “Thank you. I learned a lot from you.” Sharing resources and making referrals to your network can be helpful in solving a particular situation.

Lesson Four – Having a sense of humor is a big asset in dealing with the frustrations of hearing loss. At a job interview, the batteries in my hearing aids went dead. Very calmly, I looked at the interviewer and said, “The number you have reached is temporarily disconnected. I have to change the batteries in my hearing aids.” The look of astonishment on her face was wonderful. I had not told her I had a hearing loss when I went into the interview! My other favorite line is “Don’t speak until you can see the whites of my eyes.” It is much more effective than saying “Please face me when you speak.”

Lesson Five – Saying “please” and “thank you” are invaluable tools in smoothing the way to requests that, for one reason or another, may be difficult to fulfill. Everyone wants to be treated with respect and appreciates having their efforts recognized.

Lesson Six – Look for win-win solutions to accessibility problems. You get the accommodation. The supplier gets more business, good PR and a grateful citizenry.

Lesson Seven – Getting angry accomplishes nothing!

Lesson Eight – Join organizations like the Hearing Loss Association of America (HLAA) so you can meet others who are dealing with the same problems you are – you are not alone! – and learn as much as you can about your hearing loss, hearing aids, cochlear implants, assistive devices and helpful coping techniques. CHC also has support groups for people with hearing loss.

Learn more about CHC’s support groups »

Lesson Nine – Hearing loss is not a fatal disease. It is frustrating, annoying and difficult to cope with. Although recent research shows untreated hearing loss can affect your physical and mental health and your memory, there are a growing number of ways to address hearing loss through technology and counseling. Take advantage of them by coming to CHC and joining HLAA-NYC.

Become an HLAA-NYC Chapter Member »

Get your hearing checked at CHC »

Lesson Ten – Hearing loss is an invisible disability. Each time we speak up, we make it more visible! Become an Ambassador for Hearing, explaining what we need, why we need it, how important it is to each of us and how grateful we are for the services we receive, even if they aren’t perfect. Participating in community activities is also helpful. Please join CHC and HLAA-NYC at the New York City Disability Pride Day Parade on Sunday, July 9, 2017.

Learn more about NYC’s Disability Pride Parade »

– See more at:

Flying this Summer? Hints for Your Hearing Aids

As this year’s summer travel season approaches, news of heightened airport security is making some people with hearing aids or cochlear implants nervous about what they may encounter as they go through TSA screening.

Earlier this month, the Department of Homeland Security announced that the current ban on laptops and tablets, including some E-readers, on international flights from mostly Muslim countries in the Mideast and Africa would be extended to flights from Europe as well. After a meeting in Brussels last week, EU and American officials decided against the ban, in part because of the danger from fires in the hold caused by lithium batteries.

But the proposed ban raised the issue of electronics and security once again. Travelers with hearing aids and cochlear implants should rest assured that these will not set off alarms as you go through security screening.

It’s best to wear your hearing aids, in fact, for several reasons. The first is that they will allow you to hear questions from the TSA agents, which is important. You may even be able to hear flight announcements. The second is that hearing aids or cochlear implants and their various assistive devices in your carry-on baggage might prompt a bag search simply based on the shape and metallic content.

The best thing is to tell the security desk that you are wearing a hearing aid or cochlear implant. If the alarm goes off as you go through the security gate, it’s probably because you forgot to take off your belt or left your keys in your pocket. If you are pulled aside, explain again that you have a hearing aid or cochlear implant.

On the plane itself, you may want to remove the aids if the plane is too loud. Noise-cancelling headphones can help cut the noise and may also allow you to enjoy the inflight entertainment, which the airline-provided earbuds would probably not. (Note to airlines: We’re still waiting for captions on in-flight entertainment!)

Don’t put your hearing equipment – or any other valuables or medications – in your checked bag. Bags are too easily lost in transit. Although the bag will probably eventually make it back to you, you want to have everything essential in your carry-on luggage.

If your hearing loss prevents you from hearing announcements in noisy airports, check off “disability” when you buy your ticket. Even if you specify that your disability is hearing loss, you may be met at the gate by a wheelchair. (This has actually happened to several friends of mine!)

But you will also be offered pre-boarding, which is definitely preferable to being caught in the scrum at the boarding gate as people wait to hear their zone called.

So wear your hearing aids, keep your valuables in your carry-on bag, and don’t forget your sense of humor!


For more on traveling with hearing aids and cochlear implants, see “Traveling with Chargers (and Hearing Aids).”

For more information on living with hearing loss, see my books on




OTC Hearing Aid Act Moves Ahead

On Friday May 12, a Senate bill containing a provision for FDA-approved Over the Counter Hearing Aids passed from committee to the full Senate, where it is expected to pass.

This is an enormous step towards cheaper, more accessible hearing aids, which should help lower the cost of all hearing aids, even high-end hearing aids, which can now cost up to $6000 each, and which average about $2400 each.

This is an important bill, in my opinion, and in the opinion of other advocates for people with hearing loss, including the Hearing Loss Association of America. For more on this, see my previous post, What Exactly is an Over the Counter Hearing Aid.  The comments, especially one from Ben Kaufman, are also informative.

Here’s an article from Modern Healthcare on Friday’s committee vote:

“FDA User-fee Extension Breezes Through Senate Committee.”
The act, which calls for more than $400 million in additional user fees to be collected from the makers of prescription brand drugs, medical devices, generic drugs and “biosimilars” looks to expedite new drug approvals. The committee added amendments aimed at increasing competition.  READ MORE

What Exactly is an Over The Counter Hearing Aid?

One way or the other, it looks as if Over-the-Counter hearing aids will come on the market in the not too distant future.

In March, Senators Elizabeth Warren (D. Mass), Chuck Grassley (R. Iowa), Maggie Hassan (D-N.H.), and Johnny Isakson (R-Ga. reintroduced their bipartisan Over-the-Counter Hearing Aid bill.

On May 2, the House Energy & Commerce Subcommittee held a hearing on the proposed “Over-the-Counter Hearing Aid Act,” H.R. 1652, co-sponsored by Representative Marsha Blackburn, a conservative Republican from Tennessee, and Joseph Kennedy (D. Mass).

And now the Food and Drug Administration, which regulates the sale of hearing aids, looks like it may make legislation moot. The agency is expected to make an announcement in the near future about whether or not it will approve OTC hearing aids.

What exactly is an over the counter hearing aid?

We already have a device available over the counter that corrects hearing loss. What is it if not an OTC hearing aid?  It’s a PSAP,  a Personal Sound Amplification Product, which can cost anywhere from $50 to $500.  A PSAP can only be marketed as a sound amplifier for people with normal hearing..

So what’s an OTC hearing aid? Right now it’s a concept, not a product.

An OTC hearing would probably do pretty much what a good PSAP already does, but with FDA approval. It would be a digital device, possibly with directional microphones, Bluetooth and a telecoil, and presumably it would cost $1000 or less. An OTC hearing aid could be sold direct to the consumer, without an audiologist or hearing aid dispenser involved.

An OTC hearing aid would be subject to FDA safety and efficacy standards. Most consumer activists support this initiative, as a way of getting people to correct their hearing loss. OTC hearing aids are not for people with severe hearing loss, single sided hearing loss, or hearing loss caused by a number of medical conditions. So why do I, who can never benefit from an OTC aid, support it?

Four out of five older Americans with hearing loss decide to ignore it, so clearly something needs to change. Many of these people cannot afford hearing aids or worry about stigma. More widespread hearing devices of all kinds would help with both those issues.

Competition will bring prices down. Ubiquitous use will end stigma. Lower prices, end stigma. What’s not to like?

Addendum, 9:30 pm Weds May 10: It looks like a done deal.

From Hearing Health and Technology Matters:

WASHINGTON, D.C. — Members of the American Academy of Audiology (AAA) and International Hearing Society (IHS) learned yesterday afternoon that the Over-The-Counter Hearing Aid Act legislation has now been attached to the Medical Device User Fee and Modernization Act (MDUFA). According to AAA President Ian Windmill, the MDUFA bill is considered “must-pass” legislation and is scheduled to be voted on today in the assigned Senate committee.

Because the current OTC hearing aid legislation has sponsors from both political parties, and now that it has been attached to a must-pass bill, the likelihood of passage has increased significantly.

Turn Down the Noise!

A new national survey of adults shows that people in all age groups, from millennials to seniors, think that public spaces are too loud. Here’s a link to the study. And here’s a quick graphic version.


Forty-one percent of those polled said they were concerned that exposure to loud noise may have harmed their hearing. More than 50 percent said they worry that future noise exposure could be harmful to their hearing.

The survey, which was conducted by Crux Research for the American Speech-Language-Hearing Association, polled 1,007 people ages 18 to 70+. The largest percentage of participants were in the 18-24 and 70+ age groups.

Crotchety seniors who object to noise volume are the stereotype, but this new study found that dissatisfaction with the noise levels was highest in 18 to 29-year-olds. More than half of that group, however, said they found noisy environments more energetic or fun. Only 26 percent of the oldest participants agreed with that assessment..

The biggest culprits in terms of noise are live concerts (33 percent said they have not gone to concerts because of the noise level or have gone but the noise bothered them), bars or clubs (35 percent), sports events in a large stadium (27 percent), restaurants (25 percent) and movie theaters (21 percent).

The good news is that respondents across the board valued their hearing. More than 80 percent of those polled said their hearing status was extremely or very important. Almost three-quarters of 18 to 29 years olds answered that their hearing was important. A majority reported taking at least one step (moving away from speakers at a concert, using earplugs) to limit their noise exposure.

The survey did not ask about hearing aid use, but other studies show that despite this apparent awareness of hearing damage people are still not wearing hearing aids.

The survey was commissioned for Better Hearing and Speech Month, which is May.

What I Learned by Flunking Out of ASL

This past winter I decided to take a class in American Sign Language, ASL. It was a six-week course with a two-and-a-half hour class once a week. It was totally immersive – no spoken language allowed, even with the administrators.signlanguageabc

I took this challenge on for a couple of different reasons. The first was that I hoped to be able to exchange polite basics in ASL when I meet people who are Deaf. The second was to exercise my brain. Finally, ASL is a beautiful expressive language and in my work with the hard of hearing I often encounter someone signing. I wanted to see if I could pick up at least the most common signs.

We did learn some basics, but the class was geared more as an introductory level for people who intended to go on master ASL. In the first few classes we learned terms for discussing extended family. For instance, Is your cousin older than your brother? Who is her aunt? Are they divorced or separated? Is your youngest step-sister engaged? Clearly these are useful for conversation, especially as you get to know someone. But I couldn’t imagine myself ever asking about someone’s cousin. I found it hard enough to master father, mother, sister, brother, grandmother and grandfather to go on with other relatives.

Much of the class centered on student life. “May I borrow your slide rule?” In ASL (I think) this is “Slide rule me give?” Object subject verb, in that order. Online sources say you can use an alternate Subject Verb Object structure, which is more like spoken English, but not in my class. “Can you teach me English?” “English me teach? Help me need.” The tutor responds, “Yes. Me you pay?” (Don’t forget I flunked. This may not be correct.)

We did learn how to say Hello and Goodbye (just as you would in English, a hand signal of greeting and a little wave goodbye). “Thank you.” And “You’re Welcome” (which is “Thank You” back). “Deaf”, “hard of hearing,” and “hearing”. That was very useful. But “halter top”?

We learned how to finger spell. But we didn’t learn the alphabet from A to Z, we learned what seemed like random combinations of letters on different weeks.

The first few classes were fun. We played guessing games to increase eye-brain speed. About a third of each class was devoted to Deaf history (I did well in that) and Deaf Etiquette – some of which I was unable to comprehend. Repeatedly, in class and in quizzes, we were told that if two Deaf people are signing and you want to get past them, it is rude to walk around them. The proper etiquette is to walk right between them, without any acknowledgment that you are between them. I found this baffling but it was beyond my ability to ask about the logic of it.

My brain did feel more flexible, but only up to a certain point. We started out with six in the class, three women around my age, 50’s and 60’s, and three in their 20’s or early 30’s. One 60-year old dropped out after 20 minutes. The second made it through three classes. I made it to the end, my brain feeling ever more boggled.  Watching the teacher and then trying to repeat the signs is tricky. It’s a mirror image. It reminded me of what they always say about Ginger Rogers: She did everything Astaire did, but backwards, and in heels. Also, my aging fingers are just not as flexible as those of my 20-30-year-old fellow students.

When I spoke to the teacher about whether I should repeat Level 1 or go on to Level 2, he said I needed a private tutor. Whoa. I didn’t think I was that bad! I’ve never flunked anything. It’s humiliating!

My confidence immediately plummeted and I forgot everything I’d learned. But I didn’t want to give up so I started studying on line.

Here are some suggestions.

Print out a fingerspelling alphabet poster. Here are several to choose from. They are all free. Hang it above your desk. Teach yourself the alphabet. Then use  William Vicar’s Finger Spelling Practice. This is an increasingly difficult test-yourself site that is almost addictive. The words get longer, the fingerspelling gets faster. You can see your progress.

For those courtesy basics, go to Basic ASL: 100 Signs. The “student” in this video is a young woman who is competent but also charmingly modest and sometimes indecisive, and sometimes flat wrong. She makes you feel better about yourself. Want to learn how to count? Here’s a link.

There are many levels in this series, of increasing difficulty. You do it in your own time. I try to spend 20 minutes a day on practice, and I’m improving! My brain is also becoming more flexible. One unintended benefit is that my hand-eye coordination is improved, and it’s made a noticeable difference in my tennis game.

So I flunked ASL, but I learned a lot.

This column appeared in a slightly different form on AARP Health Essentials on May 4 2017









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