Speech, Language, and Hearing Services: Essential Coverage of Habilitation and Rehabilitation

Advocacy Toolkit

You Can Make a Difference: To learn more about becoming a Habilitation Advocate in your state, contact coverage@asha.org.

ASHA is collaborating with ASHA-recognized speech-language and hearing associations in each state and the District of Columbia to advocate for the continued coverage of speech, language, and hearing services in Affordable Care Act (ACA) health plans.

Speech, Language, and Hearing Services: Essential Coverage of Habilitation and Rehabilitation [PDF] is a tool developed by ASHA for ASHA-recognized state associations and Habilitation Advocates to use when speaking with exchange officials, insurance commissioners, and state legislators about the value of audiology and speech-language pathology services as an essential health benefit. It also outlines immediate steps you can take to protect consumer access to habilitation and rehabilitation in your state.

The toolkit also includes:

State Advocacy: Health Care is Local

States could soon adjust the list of health care services covered by ACA health plans, possibly setting lower coverage levels for habilitation and rehabilitation, which would limit access to audiology and speech-language pathology services. The changes are allowed due to federal regulations issued by the Centers for Medicare & Medicaid Services (CMS). The regulations give states more flexibility to craft benefit packages related to ACA insurance.  

In 2020, states must still offer the 10 essential health benefits (EHBs), but they will be able to update their benchmark every year and have more flexibility in deciding what benefits are covered or excluded. Under the new framework, states will be able to:

  • Keep their current benchmark plan.
  • Copy another state’s benchmark plan in its entirety.
  • Replace one or more EHB categories with the same category from another state’s benchmark. For example, state A could replace its habilitative and rehabilitative services and devices category with state B’s habilitation and rehabilitation benefit.
  • Select a new set of benefits to designate as the state’s EHB-benchmark plan.

As states consider modifying their ACA benefits, it is more important than ever to emphasize the value of habilitation and rehabilitation coverage.

Want More Information?

View a joint webinar hosted by ASHA with the American Occupational Therapy Association (AOTA) and the American Physical Therapy Association (APTA) to guide state association leaders in the EHB-benchmark selection process. Note: You will be asked to register to gain free access to the webinar.

ASHA staff are also available to offer guidance or support to audiologists and speech-language pathologists who are practicing in states considering changes to habilitation and rehabilitation coverage (e-mail coverage@asha.org).

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