As the nomination part of the election season draws to a close, it’s time to compare how each candidate stands on the important issues. Like hearing health. We at YourHearing have taken it upon ourselves to discover which of the two mainstream nominees, Hillary Rodham Clinton or Donald J. Trump, would better serve the hearing loss community. So we’re asking the tough questions of candidates. Or we did. But they didn’t answer us. Was it something we said? So we dug into their past, their websites, and the Internet to find the answers for ourselves.
On requiring health insurance or Medicaid to cover hearing aids
Hearing loss affects whole body health–emotional, cognitive, and physical. Conversely treating hearing loss improves these things. No doubt hearing health is as important as vision health. So why are glasses covered but hearing aids typically not covered by insurance? According to Atlantic Information Services, “Currently, 20 states mandate insurance coverage of hearing aids for children, while only three of those states—Arkansas, New Hampshire and Rhode Island—extend some insurance requirements to adults.” Children are covered, because it’s recognized how important hearing is to their development, and as more studies show how important hearing is to everyone, we believe, the switch to adult coverage will happen. Still the change is slow and in many states not even Medicaid includes this benefit. Although most health plans cover hearing exams, how might each candidate expand coverage for medically necessary hearing aids?
Hillary Clinton: In May of 2008, then Senator Clinton put forth a concurrent resolution supporting the goals of Better Hearing & Speech Month. In addition in March of 2007, she put forth a bill reinstating benefits for veterans which included taking care of their,“(5)Hearing loss.” These resolutions and her stance on health care demonstrate leadership that strives for easing the burden of health care expenses. Her website promotes improving health care for individuals and giving support to caregivers. Both suggest she may be open to expanding Medicaid hearing health benefits. As does the fact that her husband, former President Bill Clinton, wears hearing aids. But this is only speculation. Neither candidate has mentioned hearing health or hearing health benefits directly. Mrs. Clinton does state, however, “Fight for health insurance for the lowest-income Americans in every state by incentivizing states to expand Medicaid—and make enrollment through Medicaid and the Affordable Care Act easier.”
Donald Trump: Although, Mr. Trump doesn’t have a record in government, he does have a record amongst his employees. Workers in Trump’s Vegas hotel reportedly have an above average benefit package for health. Although workers in Trump’s Atlantic City Taj Mahal recently lost all benefits, that happened after Mr. Trump sold the Trump Taj Mahal to Carl Icahn in order to avoid bankruptcy. These workers with Local 54, a union that supports Clinton because they claim she will, “end this double-payment scheme written into the Affordable Care Act” have been striking since July 1. Still before bankruptcy for this casino, employee benefits under Mr. Trump kept pace with other companies. Additionally Mr. Trump picked Governor Mike Pence from Indiana for his VP and Indiana was, “One of several Republican-led states to expand their Medicaid programs last year under terms of the Affordable Care Act.”
Despite Mr. Trump’s goal to abolish the Affordable Care Act, both Pence and Trump support increasing use of health savings accounts (HSA) to cover medical expenses. In fact, Governor Pence enacted accounts similar to HSA for Medicaid recipients and Mr. Trump’s website extols the virtues of non-taxable health savings accounts to cover costs outside regular benefits. So basically, though he does offer employees good benefits, it does seem more likely the HSA to cover hearing aids would be more probable than Mr. Trump expanding benefits requirements to include hearing aids.
On a hearing aid tax credit
According to the Better Hearing Institute, “While 95% of individuals with hearing loss could be successfully treated with hearing aids, only about 8.4 million of the 34 million Americans with hearing loss used them in 2008.” Although it’s pennies a day and hearing loss can be harmful to the brain and result in greater healthcare costs overall many Americans can’t spend the money on hearing aids. Stressing the importance of hearing health and giving people a needed break in making the decision to medically improve changes in hearing, a bipartisan hearing aid tax credit was put forth by Dean Heller (R. Nevada). (Side Note: the senator has not yet endorsed any presidential nominee.) The hearing aid tax credit calls for $500 per hearing aid and a thousand dollars per pair every five years. So where do each of the candidates stand on this tax credit? Well, we don’t actually know. Here’s what we do know.
Hillary Clinton: Former Secretary Clinton has provided extensive information on out-of-pocket health care costs, but she doesn’t address the hearing aid tax credit by name. However, her website states, “American families are being squeezed by rising out-of-pocket health care costs. Hillary believes that workers should share in slower growth of national health care spending through lower costs.” More specifically her website supports a, “…new, progressive refundable tax credit of up to $5,000 per family for excessive out-of-pocket costs” for healthcare. Note: This tax credit would be $2,500 for an individual. Still, that’s more than the $1,000 hearing aid tax credit. Currently these refundable tax credits would cover and be applied to all citizens, after expenses for health exceed five percent of a person’s income.
Donald Trump: Mr. Trump doesn’t specify an amount for a tax deduction for healthcare costs or specifically mention out-of-pocket costs or the hearing aid tax credit but he does want to, “Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system.” Currently, if you are 65 or over you can deduct your health insurance premiums on your taxes, but only if the total exceeds ten percent of your adjusted gross income. In other words, a senior would have to spend over 5,000 dollars on medical expenses if making $50,000 a year to deduct. Mr. Trump is suggesting a universal deduction on healthcare premiums without having to meet the age or income requirement. This means no matter your age or income you can deduct all healthcare premiums from your taxes. The average costs for premiums annually vary per state, and as it turns out isn’t so easy to get a hold of this information. Here are here are two places where you can see the huge variation in the reported average insurance premium costs, http://kff.org/report-section/ehbs-2015-section-one-cost-of-health-insurance/ and http://www.valuepenguin.com/average-cost-of-health-insurance..
On increasing Flexible Spending or Health Savings Accounts to pay for hearing aids
Hearing aids are currently a qualifying purchase for Flexible Spending Accounts and Health Savings Accounts. A Flexible Spending Account (FSA) and a Health Savings Account (HSA) are accounts in which employees deposit pre-taxed money to use on health expenses not typically covered by insurance. Currently there is a cap on how much you can put into an FSA (and time use restrictions) and restrictions on those who qualify and can use an HSA. An FSA has a one-year time limit, but an HSA accumulates every year. According to Obamacare Facts.com, “HSAs aren’t “use it or lose it” they are tax free in, keep it, invest it, use it tax free on medical expenses, withdraw whenever at a fee, and roll it over into a retirement account when you are ready for Medicare. Only FSAs are “use it or lose it” (the kind of health savings account you get through your employer). The expansion of the uses on both of these types of accounts could potentially benefit those with hearing health needs.
Donald Trump: Mr. Trump’s website doesn’t mention FSA, but does speak of HSA. As noted above an HSA is different from an FSA. Not only does an HSA roll over year after year, it can also follow an employee from one employer to another. But as noted in a New York Times article, “The HSA. accounts, however, can be used only in tandem with an HSA–qualified health insurance plan that meets specific criteria, like a minimum deductible (at least $1,300 for an individual for 2015).” Mr. Trump’s website describes his healthcare policy as expanding HSAs to, “Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. (Side note: These policies are tax deductible and are already allowed to accumulate as enacted into law by George W. Bush.) These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.” Expansion of an HSA could potentially benefit those who qualify for an HSA.
Hillary Clinton: Former Secretary Clinton supports the continuation of the Affordable Care Act (ACA) and the current benefits of the FSA and the HSA—including being able to use contributions in the HSA to make investments and allowing medical, dental, and vision deductions with an HSA. In addition, she wants to take on current high premiums and deductibles. According to BallotPedia, her plan to do this includes, “Under her affordable healthcare and prescription drug plan, a patient could visit a doctor three times without it counting toward their annual deductible, families ineligible for Medicare could receive a tax credit for out-of-pocket healthcare expenses, prescription drugs for patients with chronic or serious health conditions would be capped at $250 per month, and prescription drug imports from Canada would be legal.”
On equal rights and anti-discrimination against people with hearing loss
The Americans with Disabilities Act (ADA) was an important and valuable piece of legislation enacted in 1990. Its goal was to, “Provide comprehensive civil rights protections to individuals with disabilities in the areas of employment, public accommodations, State and local government services, and telecommunications.” This legislation ensures those with disabilities have their limits acknowledged and be legally provided equal accommodation at work and in order to access U.S. services and programs. Although many strides have been made for equal access thanks to the ADA there are still many venues and places of employment that deaf and hard of hearing individuals are excluded from. So how do each of the candidates feel about equality and supporting Americans with disabilities?
Donald Trump: Although there was a big deal made when Donald Trump seemingly made fun of Rand Paul’s hearing loss during a debate, this was never proven. In fact the words Mr. Trump used, “I don’t think you heard me” could also have been seen as a cliché more than intended insult. It is troubling, however, that Mr. Trump was accused of making fun of a CNN reporter with a disability.While this joke may have been a bit out of line, don’t condemn Mr. Trump too fast, he is also a big supporter of Wounded Warriors and of Veterans who suffer from hearing loss. Here’s what his website says about veterans, “Today’s veterans have very different needs than those of the generations that came before them. The VA must adapt to meet the needs of this generation of younger, more diverse veterans. The Trump plan will expand VA services for female veterans and ensure the VA is providing the right support for this new generation of veterans.”
Hillary Clinton: Former Secretary Clinton’s website contains this information about disabilities, “As a presidential candidate, Hillary has been proud to partner with the disabilities community. She’s stood up to those who bully and belittle Americans with disabilities—and she will continue to champion their rights as president.” Indeed, Hillary Clinton has a long and detailed history of supporting Americans with disabilities. Here is a list of promises about those with disabilities present on her website:
- Work to fulfill the promise of the Americans with Disabilities Act.
- Expand support for Americans with disabilities to live in integrated community settings.
- Improve access to meaningful, gainful employment for people with disabilities.
- Provide tax relief to help the millions of families caring for aging relatives or family members with chronic illnesses or disabilities.
Although we never received a clear answer on each candidate’s stance on hearing health, YourHearing hopes that this information is valuable to you. No matter who you support this election, whether one of the mainstream candidates or someone else entirely, we hope you remember to vote this November. Voting is a way for all those with hearing health needs to help ensure health care expands to include the important hearing health services we all need to live happy and successful lives.