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

In a significant legal challenge to healthcare coverage policies, Jason Delessert, a Washington resident with hearing loss, has filed a nationwide class action lawsuit against Kaiser Foundation Health Plan. The lawsuit alleges that Kaiser's exclusion of prescription hearing aids from coverage constitutes illegal disability discrimination under the Affordable Care Act (ACA).

This case marks the first nationwide class action to bring a disability discrimination claim under the ACA on behalf of hearing-disabled enrollees requiring prescription hearing aids. It follows a previous Washington-specific case, Schmitt v. Kaiser Foundation Health Plan of Washington, which settled but did not include Delessert.

Delessert argues that prescription hearing aids are essential for his daily functioning, comparing their necessity to that of a wheelchair for individuals with mobility disabilities. He contends that Kaiser's refusal to cover hearing aids as 'durable medical equipment' under his health plan is discriminatory, especially when other enrollees receive coverage for durable medical equipment to treat their diagnosed health conditions.

Eleanor Hamburger, one of Delessert's attorneys, asserts that the exclusion of prescription hearing aids specifically targets people with hearing disabilities, which she claims is illegal discrimination. The lawsuit cites a previous court ruling in the Schmitt case, which stated that under the ACA, Kaiser has an "affirmative obligation not to discriminate in the provision of health care" and must consider the needs of disabled people when designing plan benefits.

The legal action challenges the historical discrimination against disabled individuals by the health insurance industry. Anna Prakash, another attorney representing Delessert, emphasizes that the ACA was intended to end such discrimination, including against enrollees with hearing disabilities.

This lawsuit could have far-reaching implications for healthcare coverage across the United States. If successful, it may force Kaiser and potentially other health insurance providers to reconsider their policies regarding hearing aid coverage. This could lead to improved access to essential medical devices for individuals with hearing disabilities, potentially enhancing their quality of life and ability to participate fully in society.

The case also highlights the ongoing challenges in implementing the ACA's non-discrimination provisions and could set a precedent for how health insurers approach coverage for specific disabilities. As the lawsuit progresses, it will be closely watched by healthcare providers, insurers, and disability rights advocates for its potential to reshape health insurance policies nationwide.