H.R. 477House117th Congress (2021-2023)In Committee

Ally’s Act

Sponsored by Joe NeguseRep. Joe Neguse (D-CO)
Introduced January 25, 2021

AI-Generated Summary

Updated February 7, 2026 at 9:35 PM UTC

The Ally’s Act amends the Public Health Service Act, ERISA, the Internal Revenue Code, and the Affordable Care Act to require private group health plans and insurers to cover hearing devices and related services. It applies to plans starting in 2022 and affects anyone with hearing loss who needs an FDA‑approved auditory implant or related equipment. The law also limits how much cost‑sharing can be charged for these items and services.

Key Provisions

  • Mandates coverage of FDA‑approved auditory implant devices (including cochlear and bone‑conduction implants) and external sound processors, plus maintenance, upgrades every five years, repairs, and related accessories.
  • Requires coverage of comprehensive hearing assessments, pre‑operative and post‑operative medical and audiology appointments, surgery when needed, and aural rehabilitation services.
  • Limits cost‑sharing to the highest amount charged by a physician or qualified audiologist who has a contract with the plan, ensuring patients aren’t charged more than comparable services.
  • Extends these requirements to group health plans under ERISA, to tax‑qualified plans under the Internal Revenue Code, and to plans covered by the ACA, including grandfathered plans.
  • Sets the effective date for all new coverage and cost‑sharing rules as plan years beginning on or after January 1, 2022.

Legislative Activity

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3 earlier actions
HouseCommittee Latest Action

Referred to the Subcommittee on Health.

February 2, 2021

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HouseIntro Referral

Introduced in House

January 25, 2021

HouseCommittee

Referred to the Subcommittee on Health.

January 25, 2021

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

January 25, 2021

HouseCommittee

Referred to the Subcommittee on Health.

February 2, 2021

Floor Debate

24 members

What members said about H.R. 477 on the floor

10 Republicans14 Democrats
Rep. Andy LevinD-MI-9 · Feb 5, 2021

Mr. Speaker, pursuant to House Resolution 85, I call up the bill (H.R. 447) to amend the Act of August 16, 1937 (commonly referred to as the ``National Apprenticeship Act'') and expand the national…

Virginia Foxx
Rep. Virginia FoxxR-NC-5 · Feb 5, 2021

Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today in strong opposition to H.R. 477, the National Apprenticeship Act of 2021, which impedes the ability of businesses…

Sheila Jackson Lee
Rep. Sheila Jackson LeeD-TX-18 · Feb 5, 2021

Mr. Speaker, I thank the gentleman for yielding. I rise with great promise to support H.R. 447, the National Apprenticeship Act of 2021, and thank the manager. I thank the chairman for investing $3.5…

J. French Hill
Rep. J. French HillR-AR-2 · Feb 5, 2021

Mr. Speaker, I rise in opposition of the National Apprenticeship Act. As the co-chair of the Skilled Workforce Caucus with my friend from Michigan, Congresswoman Brenda Lawrence, I have had the…

Suzanne Bonamici
Rep. Suzanne BonamiciD-OR-1 · Feb 5, 2021

Mr. Speaker, I rise in support of the bipartisan National Apprenticeship Act, which I am honored to co-lead with Chairman Scott. Last summer, I held a roundtable discussion with apprentices and pre-…

Show 8 more
Donald Norcross
Rep. Donald NorcrossD-NJ-1 · Feb 5, 2021

Mr. Speaker, I rise today to speak on the importance of the bipartisan National Apprenticeship Act of 2021. First, I would like to thank former Congresswoman Susan Davis for the work that she and…

Elise M. Stefanik
Rep. Elise M. StefanikR-NY-21 · Feb 5, 2021

Madam Speaker, I have an amendment at the desk. Madam Speaker, for more than a year, America's workers have faced unprecedented challenges and unimaginable uncertainty. Today, nearly 9 million fewer…

Earl Blumenauer
Rep. Earl BlumenauerD-OR-3 · Feb 5, 2021

Mr. Speaker, I appreciate this opportunity. In following my colleague, Ms. Bush, with an example of how we are fine- tuning the apprenticeship program, one of the secrets in this country, best-kept…

Jason Crow
Rep. Jason CrowD-CO-6 · Feb 5, 2021

Mr. Speaker, I rise today in support of my amendment. The registered apprenticeship system is one of America's most successful Federal workforce programs and has created a pathway for millions of…

David N. Cicilline
Rep. David N. CicillineD-RI-1 · Feb 5, 2021

Mr. Speaker, I thank the gentleman for yielding. Mr. Speaker, we have an obligation to ensure that America's workers have every opportunity to get ahead. Apprenticeships are a great way for…

Lisa Blunt Rochester
Rep. Lisa Blunt RochesterD-DE · Feb 5, 2021

Mr. Speaker, to Chairman Scott and the entire Committee on Education and Labor, I thank you for the time and for your hard work. Mr. Speaker, as the former labor secretary from the State of Delaware,…

Robert C. "Bobby" Scott
Rep. Robert C. "Bobby" ScottD-VA-3 · Feb 5, 2021

Mr. Speaker, I rise in support of H.R. 447, the National Apprenticeship Act of 2021, which I introduced with Congressman Fitzpatrick of Pennsylvania. Registered Apprenticeships are this nation's most…

Mr. Speaker, I rise in support of H.R. 447. Apprenticeships are well recognized as a way to help local economies grow by providing career opportunities for young people. However, the current national…

Show 11 more
Frank J. Mrvan
Rep. Frank J. MrvanD-IN-1 · Feb 5, 2021

Mr. Speaker, I rise today in support of H.R. 447, the National Apprenticeship Act of 2021. It is my distinct honor to be a member of the House Education and Labor Committee, and I am encouraged to…

Glenn Thompson
Rep. Glenn ThompsonR-PA-15 · Feb 5, 2021

Mr. Speaker, I rise today in opposition to H.R. 447, the National Apprenticeship Act of 2021. As co-chair of the Congressional Career and Technical Education Caucus, it takes a lot for me to oppose…

Glenn Grothman
Rep. Glenn GrothmanR-WI-6 · Feb 5, 2021

Mr. Speaker, apprenticeship programs are incredibly important for job growth in the State of Wisconsin and around the Nation; and insofar as this bill highlights apprenticeships, that is a good…

Scott Perry
Rep. Scott PerryR-PA-10 · Feb 5, 2021

Mr. Speaker, we all want to help. We all want to help the people in our community find their way; do better for themselves; seek the opportunities that support themselves, their dreams, and their…

Marcy Kaptur
Rep. Marcy KapturD-OH-9 · Feb 5, 2021

Mr. Speaker, I include in the Record support for this bill from the National Electrical Contractors Association. [From NECA, February 1, 2021] Media Contact: Matt Kraus, Director, Communications…

Derek Kilmer
Rep. Derek KilmerD-WA-6 · Feb 5, 2021

Mr. Speaker, I rise today in support of this package of en bloc amendments, which includes a bipartisan amendment I offered to expand access to computer science youth apprenticeship programs that are…

Joe Courtney
Rep. Joe CourtneyD-CT-2 · Feb 5, 2021

Mr. Speaker, in 1937, a freshman Member of Congress who held my seat, Representative William Fitzgerald, from Norwich, Connecticut, led the effort to pass the first National Apprenticeship Act. After…

Russ Fulcher
Rep. Russ FulcherR-ID-1 · Feb 5, 2021

Mr. Speaker, I rise in opposition to H.R. 447, the National Apprenticeship Act. This bill invites continued Federal rules that hinder Idaho's ability to use industry-based standards. There is a lot…

Tim Walberg
Rep. Tim WalbergR-MI-7 · Feb 5, 2021

Mr. Speaker, I rise in opposition to H.R. 447, the National Apprenticeship Act, not opposition to the gold standard, labor union apprenticeship programs. Updating our national apprenticeship system…

Earl L. "Buddy" Carter
Rep. Earl L. "Buddy" CarterR-GA-1 · Feb 5, 2021

Mr. Speaker, I rise today in opposition to the National Apprenticeship Act. Like so many issues we debate here, we have a common desire to help the American people, but we disagree about how to go…

Rick W. Allen
Rep. Rick W. AllenR-GA-12 · Feb 5, 2021

Mr. Speaker, I rise today in strong opposition to H.R. 447. Coming from the construction industry, I know firsthand that apprenticeships help Americans gain valuable skills that lead to good- paying…

Bill Text

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Introduced in HouseIssued January 25, 2021

I

117th CONGRESS

1st Session

H. R. 477

IN THE HOUSE OF REPRESENTATIVES

January 25, 2021

Mr. Neguse (for himself, Mr. McKinley, and Mr. Thompson of California) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, the Internal Revenue Code of 1986, and the Patient Protection and Affordable Care Act to require coverage of hearing devices and systems in certain private health insurance plans, and for other purposes.

1.

Short title

This Act may be cited as Ally’s Act.

2.

Coverage of hearing devices and systems in certain private health insurance plans

(a)

PHSA

Part A of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended by inserting after section 2713 the following new section:

2713A.

Coverage of hearing devices and systems

(a)

In general

Beginning with plan years beginning on or after January 1, 2022, a group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum provide coverage for and may impose cost-sharing requirements in accordance with subsection (b) for an individual that a physician (as defined in section 1861(r) of the Social Security Act) or qualified audiologist (as defined in section 1861(ll)(4)(B) of such Act) determines meets an indication (including unilateral or bilateral hearing loss) for an auditory device as approved by the Food and Drug Administration for—

(1)

auditory implant devices (including auditory osseointegrated (bone conduction) implants and cochlear implants) and external sound processors;

(2)

the maintenance of auditory implant devices and external sound processors described in paragraph (1);

(3)

every 5 years, the upgrade (or replacement if an upgrade is not available) of auditory implant devices and external sound processors described in paragraph (1);

(4)

adhesive adapters and softband headbands;

(5)

the repair of auditory implant devices and external sound processors described in paragraph (1);

(6)

a comprehensive hearing assessment;

(7)

a preoperative medical assessment;

(8)

surgery (as appropriate);

(9)

postoperative medical appointments for purposes of ensuring appropriate recovery from surgery;

(10)

postoperative audiological appointments for activation and fitting of the implant device and external sound processor; and

(11)

aural rehabilitation and treatment services (as appropriate).

(b)

Cost-Sharing

Beginning with plan years beginning on or after January 1, 2022, the cost-sharing incurred under a plan or coverage described in subsection (a)—

(1)

for an auditory implant device and external sound processors under this section, shall not exceed a dollar amount that is the highest cost-sharing requirement for the amount of the charges imposed for such device that is provided by a physician or qualified audiologist that has a contractual relationship with such plan or coverage for the providing of such device;

(2)

for an item or service under this section, shall not exceed a dollar amount that is imposed for similar items and services under that plan that are provided by a physician or qualified audiologist; and

(3)

that has a contractual relationship with such plan or coverage for the providing of such items and services.

.

(b)

ERISA

(1)

In general

Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) by adding at the end the following new section:

726.

Coverage of hearing devices and systems

(a)

In general

Beginning with plan years beginning on or after January 1, 2022, a group health plan and a health insurance issuer offering group or health insurance coverage shall, at a minimum provide coverage for and may impose cost-sharing requirements in accordance with subsection (b) for an individual that a physician (as defined in section 1861(r) of the Social Security Act) or qualified audiologist (as defined in section 1861(ll)(4)(B) of such Act) determines meets an indication (including unilateral or bilateral hearing loss) for an auditory device as approved by the Food and Drug Administration for—

(1)

auditory implant devices (including auditory osseointegrated (bone conduction) implants and cochlear implants) and external sound processors;

(2)

the maintenance of auditory implant devices and external sound processors described in paragraph (1);

(3)

every 5 years, the upgrade (or replacement if an upgrade is not available) of auditory implant devices and external sound processors described in paragraph (1);

(4)

adhesive adapters and softband headbands;

(5)

the repair of auditory implant devices and external sound processors described in paragraph (1);

(6)

a comprehensive hearing assessment;

(7)

a preoperative medical assessment;

(8)

surgery (as appropriate);

(9)

postoperative medical appointments for purposes of ensuring appropriate recovery from surgery;

(10)

postoperative audiological appointments for activation and fitting of the implant device and external sound processor; and

(11)

aural rehabilitation and treatment services (as appropriate).

(b)

Cost-Sharing

Beginning with plan years beginning on or after January 1, 2022, the cost-sharing incurred under a plan or coverage described in subsection (a)—

(1)

for an auditory implant device and external sound processors under this section, shall not exceed a dollar amount that is the highest cost-sharing requirement for the amount of the charges imposed for such device that is provided by a physician or qualified audiologist that has a contractual relationship with such plan or coverage for the providing of such device;

(2)

for an item or service under this section, shall not exceed a dollar amount that is imposed for similar items and services under that plan that are provided by a physician or qualified audiologist; and

(3)

that has a contractual relationship with such plan or coverage for the providing of such items and services.

.

(2)

Clerical amendment

The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.) is amended by inserting after the item relating to section 725 the following new item:

Sec. 726. Coverage of hearing devices and systems.

.

(c)

IRC

(1)

In general

Subchapter B of chapter 100 of the Internal Revenue Code of 1986, is amended by adding at the end the following new section:

9286.

Coverage of hearing devices and systems

(a)

In general

Beginning with plan years beginning on or after January 1, 2022, a group health plan shall, at a minimum provide coverage for and may impose cost-sharing requirements in accordance with subsection (b) for an individual that a physician (as defined in section 1861(r) of the Social Security Act) or qualified audiologist (as defined in section 1861(ll)(4)(B) of such Act) determines meets an indication (including unilateral or bilateral hearing loss) for an auditory device as approved by the Food and Drug Administration for—

(1)

auditory implant devices (including auditory osseointegrated (bone conduction) implants and cochlear implants) and external sound processors;

(2)

the maintenance of auditory implant devices and external sound processors described in paragraph (1);

(3)

every 5 years, the upgrade (or replacement if an upgrade is not available) of auditory implant devices and external sound processors described in paragraph (1);

(4)

adhesive adapters and softband headbands;

(5)

the repair of auditory implant devices and external sound processors described in paragraph (1);

(6)

a comprehensive hearing assessment;

(7)

a preoperative medical assessment;

(8)

surgery (as appropriate);

(9)

postoperative medical appointments for purposes of ensuring appropriate recovery from surgery;

(10)

postoperative audiological appointments for activation and fitting of the implant device and external sound processor; and

(11)

aural rehabilitation and treatment services (as appropriate).

(b)

Cost-Sharing

Beginning with plan years beginning on or after January 1, 2022, the cost-sharing incurred under a plan described in subsection (a)—

(1)

for an auditory implant device and external sound processors under this section, shall not exceed a dollar amount that is the highest cost-sharing requirement for the amount of the charges imposed for such device that is provided by a physician or qualified audiologist that has a contractual relationship with such plan for the providing of such device;

(2)

for an item or service under this section, shall not exceed a dollar amount that is imposed for similar items and services under that plan that are provided by a physician or qualified audiologist; and

(3)

that has a contractual relationship with such plan for the providing of such items and services.

.

(2)

Clerical amendment

The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by inserting after the item relating to section 9825 the following new item:

Sec. 9286. Coverage of hearing devices and systems.

.

(d)

Application to grandfathered health plans

Section 1251(a)(4)(A) of the Patient Protection and Affordable Care Act (42 U.S.C. 18011(a)(4)(A)) is amended—

(1)

by striking title and inserting title, or as added after the date of the enactment of this Act); and

(2)

by adding at the end the following new clause:

(v)

Section 2713A (relating to hearing devices and systems).

.

(3)

Effective date

The amendments made by this subsection shall apply with respect to plan years beginning on or after January 1, 2022.