Earlier this year, Ohio enacted “Madeline’s Law,” which took effect April 3, 2025, without regard to plan year or an insurance policy’s renewal date. It requires medical plans to provide first dollar coverage for medically appropriate hearing aids for participants who are 21 years old or younger.
Madeline’s Law applies to medical plans subject to Ohio’s insurance law (i.e., fully insured plans and self-insured, non-ERISA plans). Self-insured ERISA plans may claim ERISA preemption and avoid the insurance mandate. As currently written, Ohio’s insurance mandate will disqualify affected high deductible health plans (HDHPs) for federal tax purposes, making plan participants ineligible to make or receive HSA contributions.
This alert is most relevant for employers who offer qualified HDHPs subject to Ohio insurance law. It addresses what appears to be the unintended conflict between Madeline’s Law and HDHPs, the possibility that Ohio will resolve the conflict, and steps employers with HDHPs may wish to take to protect themselves in the meantime.
