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Another percentage point results from new state laws requiring coverage of hearing aids and certain treatments for autism, Mr. Capozzi said.
One quarter of older and disabled people now opt out of the traditional, government-run Medicare program in favor of private plans that often have lower premiums and extra benefits, such as coverage of hearing aids.
However, the former carries the benefit that it seems able to reach a higher coverage of hearing aids services and it can be combined with the screening and management of other diseases in the community.
Active screening programs seem to be better able than passive screening programs to reach a higher coverage of hearing aids services in the community, and whether this is worth the slightly higher costs is a matter of judgment.
Active screening and provision of hearing aids at the secondary care level is slightly more costly than passive screening and fitting of hearing aids at the tertiary care level, but seems also able to reach a higher coverage of hearing aids services.
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In his latest budget request, state officials said, Governor Bush proposed to end most Medicaid coverage of eyeglasses, hearing aids and dental care for adults.
Medicaid coverage for hearing services varies by state, and some patients might not have had coverage and couldn't afford to pay out of pocket.
They are also not mandated legally to offer this sort of benefit and coverage to deaf and hard of hearing Americans, so what they are offering in terms of services is optional.
The high cost of hearing aids and lack of insurance coverage are only part of the problem.
"It seems that some of their best policy improvements, like this one, come on the eve of a public safety hearing, which then slants coverage of the hearing toward their new policy," Mr. Vallone said.
THE COVERAGE -- C-Span and PBS will provide continuous live coverage of the hearing.
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