It’s Time to Expand Telehealth for All Americans

As the novel coronavirus pandemic has now hit all 50 states, it is not only putting enormous stress on our nation’s health care systems and medical professionals, it is taking a toll on our personal lives. However, there is one relatively simple solution that would address both the imperative to preserve the limited, critical resources of our health care providers, and the need to keep Americans in their homes and out of hospital waiting rooms: We must dramatically expand access to telehealth services. Recognizing this need, Congress and the administration have taken initial steps to enhance telehealth for those in the Medicare program, but they need to go further to make these important tools available for all Americans – and quickly.

The benefits of using telehealth during a pandemic are considerable. First, it will help limit exposure for both patients and health care providers. Telehealth enables those experiencing mild COVID-19 symptoms to seek care from home without infecting others and decreases risk for patients with other illnesses needing treatment. Second, it will expand access to health care providers to bring some relief from our current workforce shortages and what we can anticipate based on what we have seen in other countries experiencing this crisis. Telehealth services would enable providers, including specialists, from less-hard hit communities to deliver remote care and allow asymptomatic, quarantined providers to deliver care remotely.

Congress passed the Coronavirus Preparedness & Response Supplemental Appropriations Act (H.R. 6074) in early March, expanding the number of Medicare beneficiaries who can receive telehealth care in their homes. The administration’s announcement this week built on this effort and expanded access to care by providing regulatory flexibility around the use of telehealth for all Medicare beneficiaries. Seniors across the country will now have easier access to telehealth appointments in addition to non-face-to-face communications, such as virtual check-ins and e-visits, for both urgent needs and routine care, in all settings, including their homes. The administration also made it easier for providers to offer telehealth services to their Medicare patients with waived or reduced cost-sharing. These actions will protect seniors and help limit the strain of this pandemic on our health care system.

We applaud these critical actions, but urge the following additional steps immediately to address critical health care needs both during this pandemic and going forward:

1. Congress and states should require that telehealth visits are covered and reimbursed at the same rate as in-person visits across originating sites for individuals covered by private insurance and Medicaid, similar to the recent changes to do this in the Medicare program.
2. The administration should continue to build on the regulation allowing medical professionals to work across state lines during this time of crisis and make this process as clear and unburdensome as possible. Congress and states should take steps to allow providers to use telehealth services across state lines even after the pandemic is over to help meet the health care needs of vulnerable populations, especially those in rural communities.
3. Congress, the administration, and states should waive cost-sharing for telehealth and other non-face-to-face care management services in Medicare, Medicaid, and private insurance during this public health emergency. While recent changes by the administration made it easier for providers to deliver this care without cost-sharing, this change should be required of all payers and providers to ensure that patients do not face a cost burden while accessing telehealth tool during this crisis.
4. Congress and the administration should remove restrictions that prevent full utilization of currently available technology for telehealth by expanding these tools to include non-face-to-face services and text (as letters/words) or other written information shared by phone or email. 
5. Congress, the administration, and states should invest in expanding access to broadband internet to every community.

These steps should be taken now during this pandemic, but widespread access to telehealth should not be limited to times of crisis. These tools should be available every day to millions of Americans with limited access to health care. They are particularly important in rural and tribal communities, which face access challenges caused by a surge of hospital closures and persistent workforce shortages, as well as for individuals seeking mental health care. In April, the Bipartisan Policy Center will release a series of recommendations to improve access to quality health care in rural communities. Improving access to telehealth across the country has been and will continue to be a critical element of our work.

We urge Congress, the administration, and states to take these important steps to improve access to quality health care through telehealth to address the health care needs of Americans today and in the future.

Tom Daschle, a South Dakota Democrat, is a former Senate majority leader and co-founder of the Bipartisan Policy Center. Olympia Snowe is a former Republican Senator from Maine and senior fellow at BPC. They both co-chair BPC’s Rural Health Task Force.