In a significant legal challenge to health insurance practices, Jason Delessert, a Washington resident with hearing loss, has initiated a nationwide class action lawsuit against Kaiser Foundation Health Plan. The lawsuit alleges that Kaiser's exclusion of prescription hearing aids from health 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 who require prescription hearing aids. It follows a previous Washington-specific case, Schmitt v. Kaiser Foundation Health Plan of Washington, which addressed similar exclusions but did not include Mr. Delessert in its settlement.
Mr. 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 states, "I need prescription hearing aids all day long, to communicate, work, socialize – in essence to safely and fully live my life." Despite this, Kaiser refuses to cover hearing aids as 'durable medical equipment' under his health plan.
The lawsuit contends that Kaiser's policy discriminates against individuals with hearing disabilities by excluding coverage for devices that specifically treat their condition, while providing coverage for durable medical equipment to treat other diagnosed health conditions. Eleanor Hamburger, one of Mr. Delessert's attorneys, asserts that this exclusion is "illegal discrimination, and Kaiser knows it."
The legal challenge is grounded in the ACA's provisions against discrimination in healthcare. The Act imposes an "affirmative obligation not to discriminate in the provision of health care" on insurers, particularly emphasizing the need to consider the requirements of disabled individuals when designing plan benefits. Despite a ruling in the Schmitt case four years ago that highlighted this obligation, Kaiser reportedly continues to apply a categorical hearing aid exclusion in Mr. Delessert's health plan and many others across the country.
Anna Prakash, another attorney representing Mr. Delessert, points out that hearing aid exclusions are rooted in historical discrimination against disabled people by the health insurance industry. She emphasizes that the ACA was intended to end such discriminatory practices, including those affecting enrollees with hearing disabilities.
This lawsuit has broader implications for the healthcare industry and individuals with hearing disabilities nationwide. If successful, it could lead to significant changes in how health insurers cover hearing aids and other assistive devices for individuals with hearing loss. The case highlights ongoing challenges in healthcare accessibility and equity, particularly for those with disabilities.
The outcome of this lawsuit could potentially impact millions of Americans with hearing loss who rely on prescription hearing aids. It raises important questions about the interpretation and implementation of the ACA's non-discrimination provisions and could set a precedent for how health insurers approach coverage for disability-specific medical equipment.
As the case progresses, it will likely draw attention to the broader issue of healthcare accessibility for individuals with various disabilities and may prompt a reevaluation of insurance policies across the industry. The lawsuit serves as a reminder of the ongoing struggle for equal access to healthcare and the critical role that legal action can play in advancing the rights of individuals with disabilities.
