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(AP) - Wisconsin lawmakers acted Thursday to
become the first state to require insurance companies to cover
cochlear implants for children with severe hearing problems.


      Both houses of the Democratic-controlled Legislature approved a
bill that requires private health insurance plans to cover cochlear
implants, hearing aids and related treatment for anyone under the
age of 18. Gov. Jim Doyle, a Democrat, will sign it into law, a
spokeswoman said.


      While hearing aids help some children with hearing loss, those
with more severe problems may be candidates for cochlear implants.
The devices turn sound into electrical impulses that activate the
hearing nerve, allowing the deaf to hear.


      Supporters say too many families with deaf children cannot
afford to pay for implants that cost $50,000 or more when their
insurance policies exclude them. 


They say getting the devices as
early as possible is critical to help children develop their
language skills.


      "This bill is going to allow children to keep their hearing, to
become members of society, to go to school and keep a job," said
Rep. David Cullen, D-Milwaukee.

      While several states require insurance companies to cover some
hearing aid costs, advocates said Wisconsin would be the first to
extend the mandate to cochlear implants.


      The mandate applies to the roughly 1.6 million residents, or 30
percent of Wisconsin's population, who are covered under private
insurance plans regulated by the state. 


Others in self-funded plans
favored by many big businesses will not be bound by the mandate.
Most government-funded plans such as Medicaid already cover the
devices.


      Ann Brensel of Fort Atkinson, whose daughter Abigail was born in
2005 with profound hearing loss, was part of a coalition of parents
who pushed lawmakers to act. The family tried to get her a cochlear
implant before she turned 1 but was denied by their insurance
company, which had a policy of excluding the devices from coverage.


      Abigail finally got the device implanted in her left ear last
year after her husband switched jobs and added his insurance
coverage on top of hers. Still, the initial denial delayed
Abigail's language development and put a strain on the family's
finances.


      Her mother said Abigail will now have to go to a special school
about 35 miles away in Waukesha rather than the local elementary
school. The family, meanwhile, has struggled to afford the $800
monthly cost of both insurance premiums and has fallen behind on
mortgage and car payments.

      "There really was no reason she should have had to lose two
years of precious time when she could have been learning sounds and
learning to use her voice," Ann Brensel said. "I hope this bill
helps the next family not to go through what we had to go
through."


      The measure passed the Senate on a voice vote and by an 80-16
margin in the Assembly.


      Opponents, who included some Republicans and business groups,
complained the mandate would drive up costs for small businesses
and employees struggling to afford health care costs.


      "Today, you're not voting for hearing aids and cochlear
implants," Rep. Leah Vukmir, R-Wauwatosa, told her colleagues.
"You're voting to take away insurance for employees who work for
small businesses."


      The potential cost of the mandate is unclear and will vary
widely by company, said Phil Dougherty, senior executive officer of
the Wisconsin Association of Health Plans. He said some of its
members already provide coverage for hearing aids and cochlear
implants while others do not.


      "More people will be seeking cochlear implants because now it's
a covered benefit," he said. "Anytime you mandate, you add
coverage for something, you are most likely adding to the cost of
that coverage."


      The bill allows insurers to apply routine cost-sharing
provisions for the procedures.


      Wisconsin's insurance commissioner estimated last year that a
similar, but slightly less-generous version of the bill would cost
people enrolled in private insurance plans less than 10 cents per
month. The analysis estimated that 1,200 kids in Wisconsin schools
were deaf and up to one-third of them had cochlear implants.

      Supporters said the mandate would save taxpayers money in the
long run by reducing special education costs and allowing more
people born deaf to enter the workforce.


      David Friedland, a doctor with the Koss Cochlear Implant Program
at the Medical College of Wisconsin, said the center performs about
100 surgeries to implant the devices per year, half of them on
children.


      "This will help with the small number of people who are
candidates, but carry insurance that has a specific rider that
excludes cochlear implants," he said. "This will allow those
people now to hear."

Gallery

A new fight over cochlear ear implants

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Politics and Government News

Both houses of the Wisconsin Legislature approved a bill that requires private health insurance plans to cover cochlear implants, hearing aids and related treatment for anyone under the age of 18.

Wis. could be first to require coverage for cochlear implants

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