COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:0167H.02C Bill No.:HCS for HB Nos. 177 & 469 Subject:Health Care; Health Care Professionals; Medicaid/MO HealthNet Type:Original Date:February 5, 2025Bill Summary:This proposal provides for MO HealthNet coverage of hearing aids and
cochlear implants.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2026FY 2027FY 2028General Revenue($12,500)Up to ($2,491,096)Up to ($663,254)Total Estimated Net
Effect on General
Revenue($12,500)Up to ($2,491,096)Up to ($663,254)
ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on Other State
Funds $0$0$0
Numbers within parentheses: () indicate costs or losses. L.R. No. 0167H.02C
Bill No. HCS for HB Nos. 177 & 469
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February 5, 2025
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ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Federal* $0$0$0Total Estimated Net
Effect on All Federal
Funds $0$0$0
* Income and expenses are estimated at $7.9 million in FY26 and $2.1 in FY27 and ongoing and
net to $0.
ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)FUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on FTE 000
☒ Estimated Net Effect (expenditures or reduced revenues) expected to exceed $250,000 in any
of the three fiscal years after implementation of the act or at full implementation of the act.
☐ Estimated Net Effect (savings or increased revenues) expected to exceed $250,000 in any of
the three fiscal years after implementation of the act or at full implementation of the act.
ESTIMATED NET EFFECT ON LOCAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Local Government$0$0$0 L.R. No. 0167H.02C
Bill No. HCS for HB Nos. 177 & 469
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FISCAL ANALYSIS
ASSUMPTION
§ 208.152 - MO HealthNet coverage of hearing aids and cochlear implants
Officials from the Department of Social Services (DSS), MO HealthNet Division (MHD)
identified 193,308 adults who are currently enrolled in MHD Fee-for-Service could be eligible
for hearing aid services. Using data from the CDC, MHD estimates that 7.1% (13,725) of those
adults may utilize these services. The average cost of hearing aid services is $210.73.
This legislation would also result in an impact to the Managed Care capitation rates of up to $10
million. The cost of the actuarial study to evaluate this program change would be no more than
$25,000 in the first year.
Due to the timing of obtaining a State Plan Amendment (SPA) and waiver for this legislation,
MHD assumes additional costs for hearing aid services will begin in FY27. MHD estimates 80%
of the participants identified will obtain hearing aid services in the first year due to pent-up
demand, and 20% in subsequent years. A 6.5% medical inflation rate was used for FY28.
FY26 Total: $25,000 (GR: $12,500; Federal: $12,500)
FY27 Total: Up to $10,313,793 (GR: $2,491,096; Federal: $7,822,697)
FY28 Total: Up to $2,746,047 (GR: $663,254; Federal: $2,082,793)
Oversight does not have information to the contrary and therefore, Oversight will reflect the
estimates as provided by the DSS.
Officials from the Department of Mental Health assume the proposal will have no fiscal
impact on their organization. Oversight does not have any information to the contrary.
Therefore, Oversight will reflect a zero impact in the fiscal note. L.R. No. 0167H.02C
Bill No. HCS for HB Nos. 177 & 469
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FISCAL IMPACT – State GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028GENERAL REVENUECosts – DSS/MHD (§ 208.152) p. 3Up to…Up to… Actuarial study ($12,500)$0$0 Coverage of hearing devices$0($2,491,096)($663,254)Total Costs - DSS/MHD
($12,500)
Up to
($2,491,096)
Up to
($663,254)
ESTIMATED NET EFFECT ON
GENERAL REVENUE($12,500)
Up to
($2,491,096)
Up to
($663,254)
FEDERAL FUNDSIncome – DSS/MHD (§ 208.152)
Program reimbursements for coverage
of hearing devices p. 3$12,500
Up to
$7,822,697
Up to
$2,082,793
Costs – DSS/MHD (§ 208.152) p. 3 Up to…Up to… Actuarial study ($12,500)$0$0 Coverage of hearing devices$0($7,822,697)($2,082,793)Total Costs - DSS/MHD
($12,500)
Up to
($7,822,697)
Up to
($2,082,793)
ESTIMATED NET EFFECT ON
FEDERAL FUNDS$0$0$0
FISCAL IMPACT – Local GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028$0$0$0
FISCAL IMPACT – Small Business
Small hearing aid businesses could see an increase in customers as a result of this proposal. L.R. No. 0167H.02C
Bill No. HCS for HB Nos. 177 & 469
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FISCAL DESCRIPTION
Currently, MO HealthNet payments made for eligible needy children, pregnant women, and
blind persons include hearing aids. This bill authorizes MO HealthNet coverage of hearing aids
and cochlear implants for all eligible needy persons as described in Chapter 208, RSMo.
(§ 208.152)
This legislation is not federally mandated, would not duplicate any other program and would not
require additional capital improvements or rental space.
SOURCES OF INFORMATION
Department of Mental Health
Department of Social Services
Julie MorffJessica HarrisDirectorAssistant DirectorFebruary 5, 2025February 5, 2025