Bridging the Hearing Divide

Policy Solutions for Aging Americans

Bibliographic Data

ID11021724
AuthorsMeghana Rajashekara Swamy (0000-0001-8288-2454, The authors are with the Department of Geriatric Medicine, Yale University, New Haven, CT. Richard Marottoli and Andrew B. Cohen are also with the Yale Pepper Center for Older Adults and the Department of Veterans Affairs at West Haven, West Haven, CT.), Richard Marottoli (The authors are with the Department of Geriatric Medicine, Yale University, New Haven, CT. Richard Marottoli and Andrew B. Cohen are also with the Yale Pepper Center for Older Adults and the Department of Veterans Affairs at West Haven, West Haven, CT.), Richard A Marottoli (0000-0003-4244-1755, University of New Haven), Andrew Cohen (0000-0001-9161-8436, The authors are with the Department of Geriatric Medicine, Yale University, New Haven, CT. Richard Marottoli and Andrew B. Cohen are also with the Yale Pepper Center for Older Adults and the Department of Veterans Affairs at West Haven, West Haven, CT.)
Year2025
Volume116
Issue3
Pagese1-e10
Publication date2025-11-20
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2025.308298
PMID41264901
OpenAlexW4416538652
LanguageEN
References cited23

Hearing loss affects approximately two thirds of adults in the United States aged 70 years or older and frequently remains untreated despite its well-documented harms, including accelerated cognitive decline, increased caregiver burden, and higher health care expenditures. We examine the major barriers to accessing high-quality hearing care, with particular attention to the complex and fragmented landscape of insurance coverage across Medicare, Medicaid, the US Department of Veterans Affairs, private plans, and over-the-counter (OTC) products. We review key legislative and regulatory developments over the past decade, most notably the 2022 establishment of OTC hearing aids, and summarize early opportunities and remaining gaps. We then propose targeted reforms to improve access and affordability, including more consistent Medicaid benefits, selective Medicare expansion, integration of teleaudiology, and strengthened oversight and consumer protections for OTC devices. Finally, we advance a technology-driven policy framework that integrates artificial intelligence–supported risk prediction, teleaudiology, real-time insurance verification, and a transparent device marketplace to modernize delivery and evaluation. Together, these strategies can catalyze a fundamental rethinking of how hearing health is prioritized and managed within the broader United States health care ecosystem. ( Am J Public Health. Published online ahead of print November 20, 2025:e1–e10. https://doi.org/10.2105/AJPH.2025.308298 )

Bridging (networking) · Health care · Healthy aging · Hearing loss · Legislature · Medicaid · Patient Protection and Affordable Care Act · Public health · Healthcare Technology and Patient Monitoring · Hearing Loss and Rehabilitation · Hearing, Cochlea, Tinnitus, Genetics · Health Policy

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