When the COVID-19 pandemic led to lockdowns and shutdowns, an immediate and critical challenge was how to obtain access to medical care without seeing a healthcare provider in person.   The quick expansion of the availability and use of telemedicine by the federal and state governments helped to resolve this problem across the country.  McKinsey & Company’s Healthcare and Services Division reported that telemedicine usage increased from 11 percent to 46 percent in the first quarter of 2020 compared to the first quarter of 2019, and the Department of Health and Human Services (HHS) reported that there was an increase in Medicare visits that were conducted using telemedicine services from 0.1 percent in February 2020 to 43.5 percent in April 2020. 

On August 3, 2020, former President Donald Trump signed an executive order expanding telemedicine services during the pandemic, with a focus on rural communities.  The executive order also extended telemedicine services to continue even after the pandemic ends.

Sen. Brian Schatz (D-Hawaii) introduced the Connect for Health Act, which would permanently remove geographic restrictions on telemedicine, as the current waivers expire at the end of 2021.  Rep. Mike Thompson (D-Calif.) has introduced similar legislation, While Rep. Lloyd Doggett’s (D-Tex.) bill would extend telemedicine waivers until 2022. 

States are moving faster than Congress to permanently expand access to telemedicine. 

Texas Governor Greg Abbott signed legislation on June 15, 2021, that would permanently provide access to telemedicine services in the state.  The law requires the Health and Human Services Commission to “establish policies and procedures to improve access to care under the Medicaid managed care program by encouraging the use of telehealth services, telemedicine medical services, home telemonitoring services, and other telecommunication or information technology under the program.”  It will also ensure that audio-only technology will be available to individuals.  

Before Arkansas Governor Asa Hutchinson announced that he would not renew the state’s Emergency Order, which expired May 30, 2021, the legislature amended the Telemedicine Act to allow healthcare professionals to continue using technology to communicate with patients, given that the healthcare professional can access the patient’s health records.  Non-controlled drugs can also be prescribed during telemedicine meetings.  Governor Hutchinson signed the bill and it went into effect on April 21, 2021. 

But in California, there are concerns that the state’s net neutrality law, which passed in 2018, will undercut access to telemedicine for veterans.  The law imposes strict restrictions on fixed and mobile internet service providers (ISPs), including prohibiting a practice known as “zero rating,” under which ISPs offer free or subsidized data services to veterans and others that help with connecting to telehealth resources.  Internet providers in California said that the VA could potentially “end agreements offering free, subsidized data to veterans” who use the application.   The Department of Veterans Affairs (VA) raised similar concerns that veterans across the country could lose access to VA Video Connect.

As state legislative sessions are winding down, lawmakers should ensure their constituents are permanently able to use telemedicine to allow individuals who live in remote areas or otherwise cannot immediately get in to see a provider in person have continued access to healthcare.