According to our latest research, roughly a quarter of American adults report hearing loss. Still, millions have not invested in a hearing aid or even had their problem diagnosed by a doctor. That begs the question: Why are so many Americans with hearing loss skipping out on hearing aids?

The Biden administration thinks accessibility is a big part of the problem and has recently taken a significant step to make hearing aids easier to access at dramatically lower costs. The Food and Drug Administration is rolling out a long-anticipated policy change: Many hearing aids will no longer require a prescription and can be purchased over the counter online or in stores. That means fewer barriers to access and likely lower prices for millions of Americans who need them.

Over the last few years, Seniorliving.org has studied hearing aid usage among Americans, but this year we wanted to see how these new policy changes may help to put a dent in undertreated hearing loss. To find out, we conducted a study of nearly 1,500 adults. Here are our main findings:

• Millions of Americans (roughly a quarter of U.S. adults, or 62 million people) suffer from hearing loss. Of that group, only about a third have not gotten hearing aids or even seen a doctor for their issues.
• Price, access to a doctor and lack of a prescription are among the biggest factors limiting hearing aid use for those who need them.
• O-T-C hearing aids are sure to improve accessibility and price, but how large that impact will be is still hard to say. Our research estimates that 16 million people may buy an O-T-C hearing aid in the next year.

American hearing loss: widespread and undertreated

According to our study, nearly 25% of American adults struggle with hearing loss at some level. That figure is even higher for those over 55.

Most Americans with hearing loss (70%) report mild hearing difficulty. This means they have trouble hearing quiet conversations, mainly when there is a lot of background noise. Nearly a quarter have moderate hearing loss, which requires them to watch TV at a louder volume or have difficulty understanding speech. Around 5% have severe hearing loss, meaning group conversations and other activities are challenging at average volumes. Roughly 1% of those with hearing loss have a profound loss. This means assistive devices do little to help them hear, and they’re functionally deaf.

Why adults with hearing loss don’t use hearing aids

About a third of adults with self-reported hearing loss never had it diagnosed by a medical professional. Additionally, almost half of adults who reported loss use don’t use assistive devices to help them with the problem, such as hearing aids or wireless headphones.

There are a few main reasons why those with hearing problems don’t use hearing aids. First, many people with hearing loss felt they could manage without assistive devices. Around 40% of others didn’t have a prescription for hearing aids, and hearing aid price was a key obstacle for about 27%. Others said that their doctor didn’t find hearing aids necessary, or they used other technology to assist them, such as closed captioning.

Overall, cost was slightly more likely to be a barrier for people 55 or older than the general population. Compared to last year, people 55 or older were also slightly more likely this year to say that they didn’t use hearing aids because of the cost. This could be due to many factors, including inflation. However, this year, people in the 55 and up age group were less likely to feel they could manage without hearing aids.

Additionally, we know that the stigma surrounding hearing aids keeps many Americans from enjoying an easier, more empowered life. Ruth Reisman, an audiologist who sat down with Seniorliving.org to discuss the recent changes from the FDA, said, “A lot of people don’t want the social stigma of being seen with [a hearing aid].” She said that some people simply don’t like how they look or fear that others would judge them for having a disability.

However, Reisman assures that hearing aids are worth the investment, citing considerable changes in the quality of life for adults who make the switch. In addition to the practical benefits of improved hearing, she said there tends to be a positive impact on rates of depression and other mental health challenges, likely due to smoother socializing and a greater sense of independence.

While enthusiastic about O-T-C hearing aids, Reisman still recommends those with hearing issues visit an audiologist. She says a doctor can help diagnose differences in hearing loss between the two ears, physical trauma or ear diseases, or improper hearing aid placement — all of which can’t be done at home. Even with a doctor’s visit, the new policy should save Americans money and make the process easier.

Will O-T-C hearing aids make an impact?

Millions of American adults with hearing loss would see significant benefits from using hearing aids. The question is whether or not these policy changes would help to increase access to assistive devices.

In terms of price, hearing aids should become less expensive for those with mild to moderate hearing impairment. The hearing aids are expected to cost between $300 and $500, a far cry from the current $1,000 to $5,000 range for prescription hearing aids.

Additionally, access will be greater for those who don’t want to or cannot visit an audiologist. Doctors’ visits carry their own costs and create major obstacles for those who do not have health insurance. Even with insurance (including Medicare), hearing aid examinations or fittings aren’t always covered.

These are all reasons for optimism that millions of Americans with untreated hearing loss will soon enjoy a greater connection with loved ones and higher quality of life. While federal officials are reluctant to say just how significant that impact will be, government estimates predict upwards of $2,500 in total long-run savings. Our research indicates that 16 million people are convinced and plan to purchase an O-T-C hearing aid in the next year.

A better deal for hearing aids: music to American ears

Americans have long struggled with hearing aid accessibility. Purchasing hearing aids has historically been inconvenient, expensive and difficult for millions of Americans without easy medical access or thousands of dollars to spend. The change to FDA policy, which will allow for a class of O-T-C hearing aids, seeks to change that.

The initial data is promising: O-T-C hearing aids will likely improve competition, access and price for Americans with mild to moderate hearing loss, who comprise over 90% of the hearing impaired. Though it is difficult to predict how the O-T-C hearing aid market will mature, cost savings could well be in the thousands of dollars.

Our data

SeniorLiving.org conducted an online study of 1,437 adults living in the U.S. age 18 or older. Six hundred nine were 55 or older, and 828 were between 18 and 54. Seven hundred eleven were women, 718 were men, and eight were nonbinary or did not report their gender. Respondents were asked to self-report whether or not they experienced hearing loss and to what extent. Not all respondents had been officially diagnosed by medical professionals with hearing loss.

Ryan McGonagill, Director, Industry Research, SeniorLiving.org.