The number of older adults with hearing loss increases dramatically with age, as does hearing loss severity, yet hearing aid use lags substantially behind prevalence, due, in part, to affordability and accessibility barriers for hearing care. Recent studies have demonstrated that hearing loss is closely linked to the onset of dementia; declines in cognitive, physical, and social function; and poorer health care utilization. Recent gold-standard randomized controlled trials suggest that hearing care modifies poor health outcomes in some older adults. Concurrent with research, policy efforts have attempted to narrow the gap in hearing aid ownership among older adults with hearing loss. This article reviews the evidence and gaps in research on an issue of critical health and economic importance.