In a significant legal challenge to healthcare coverage policies, Jason Delessert, a resident of Burien, Washington, has initiated a nationwide class action lawsuit against Kaiser Foundation Health Plan. The lawsuit alleges that Kaiser’s exclusion of hearing aid coverage constitutes illegal disability discrimination under the Affordable Care Act (ACA).
This groundbreaking 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 case, Schmitt v. Kaiser Foundation Health Plan of Washington, which addressed similar exclusions but was limited to Washington state insureds and settled without including Mr. Delessert.
Mr. Delessert, who relies on prescription hearing aids for daily communication, work, and social interactions, argues that these devices are as essential to his life as a wheelchair is for someone with a mobility disability. 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 of Sirianni Youtz Spoonemore Hamburger PLLC, one of Mr. Delessert’s attorneys, emphasizes that the exclusion of prescription hearing aids specifically targets individuals with hearing disabilities, which she asserts is illegal discrimination that Kaiser is aware of.
The lawsuit cites the ACA’s requirement that Kaiser has an ‘affirmative obligation not to discriminate in the provision of health care—in particular to consider the needs of disabled people and not design plan benefits in ways that discriminate against them.’ This obligation was highlighted in the Schmitt v. Kaiser Foundation Health Plan of Washington case ruling in 2020. Despite this ruling, Kaiser has continued to apply a categorical hearing aid exclusion in Mr. Delessert’s health plan and many others across the country.
Anna Prakash of Nichols Kaster, 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 argues that the ACA was designed to end such discrimination, including against enrollees with hearing disabilities, and that this lawsuit aims to ensure Kaiser terminates its discriminatory practices.
This case has significant implications for the healthcare industry and individuals with hearing disabilities nationwide. If successful, it could lead to broader coverage of hearing aids by health insurance plans, potentially improving access to these essential devices for millions of Americans with hearing loss. The lawsuit also highlights the ongoing challenges in implementing the ACA’s non-discrimination provisions and could set an important precedent for future cases involving healthcare coverage for individuals with disabilities.
The outcome of this lawsuit could have far-reaching effects on how health insurers approach coverage for assistive devices and treatments specific to various disabilities. It underscores the importance of ongoing vigilance and legal action to ensure that the healthcare system evolves to meet the needs of all individuals, regardless of their disabilities.
For those interested in learning more about litigation seeking coverage of hearing aids, information is available at Kaiser Hearing Aids Litigation and Hearing Loss Litigation.
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