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telemedicine
Medicare Defenders Slam 'Obscene' Looming Cuts to Telehealth Coverage
"We have trillions to spend on tax breaks for the rich and corporations," said one economic policy expert, "but we can't afford to cover telehealth visits for seniors?"
Feb 21, 2025
The announcement Thursday that Medicare will no longer cover many telehealth services starting April 1 prompted elder and telemedicine advocates to urge the Trump administration to continue the provision of vital remote care for millions of Americans.
According to the Medicare website, "you can get telehealth services at any location in the U.S., including your home" until March 31. Beginning April 1, "you must be in an office or medical facility located in a rural area... for most telehealth services. If you aren't in a rural healthcare setting, you can still get certain Medicare telehealth services on or after April 1."
These services include monthly kidney dialysis treatments; diagnosis, evaluation, or treatment of acute stroke symptoms; and mental and behavioral health services, including addiction treatment.
"What is the rationale for this, other than making life more difficult for many seniors?"
The announcement came as the White House signaled Republican U.S. President Donald Trump's openness to slashing Medicare's budget under the guise of the Department of Government Efficiency's (DOGE) mission of reducing "waste, fraud, and abuse."
"Unreal," economic policy expert Michael Linden
said on social media. "We have trillions to spend on tax breaks for the rich and corporations, but we can't afford to cover telehealth visits for seniors?"
One Trump supporter asked on social media: "Why is Medicare eliminating telemedicine? I'm a senior and find it very convenient. If it's fraud, figure out a way to prevent fraud. Have calls made over a government app! I want to know why!"
Congressman Ro Khanna (D-Calif.) asked, "What is the rationale for this, other than making life more difficult for many seniors?"
Campaign for New York Health executive director Melanie D'Arrigo accused Trump of "killing telehealth for seniors, because many seniors will skip seeing a doctor if they have to go in person."
"Patients skipping appointments saves money, but also leads to more preventable deaths," D'Arrigo added. "Guess which he cares about more?"
Dean Baker, senior economist at the Center for Economic and Policy Research, quipped: "Not sure who this is a handout to. I know Trump wants to burn as much fossil fuel as possible, so that is one motivation. Maybe people were getting fewer unnecessary tests with telemedicine, so the medical testing industry could also have been a factor. Any other explanations?"
Georges Benjamin, executive director of the American Public Health Association—an advocacy group for U.S. public health professionals—toldRoute Fifty's Kaitlyn Levinson Thursday that "the federal contribution is absolutely essential for [telemedicine] to be a seamless system."
However, Benjamin said that "it is unclear what the Trump administration's financial policies will be in terms of supporting telemedicine and incentivizing telemedicine."
Benjamin added that he hopes the Trump administration will "provide supplemental funding and support for states that want to beef up their telemedicine capacity."
The American Telemedicine Association (ATA), another advocacy group, last month praised Trump for temporarily expanding Medicare telehealth coverage during the Covid-19 pandemic.
"Trump can cement his legacy as the president to modernize the American healthcare system by permanently enabling omnichannel care delivery that leverages both in-person and virtual care," ATA senior vice president for public policy Kyle Zebley said in a statement.
"In doing so," Zebley added, "he will expand access to needed care for millions of patients, boost a beleaguered provider population, and create greater efficiencies and operational successes for struggling healthcare organizations."
American Medical Association president Dr. Bruce A. Scott said last month that "congressional action is required to prevent the severe limitations on telehealth that existed before the Covid-19 pandemic from being restored."
"We must make these flexibilities permanent and secure telehealth's future as an essential element of our patient toolbox, and ensure that all Americans—including rural, underserved, and historically marginalized populations—can receive full access to the care they need," Scott added.
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Southeast Abortion Clinic Wait Times Soared After Florida Ban
Before the ban, the average Florida resident lived 20 miles from a clinic and would need to wait five days to access an abortion; after the ban, the driving distance jumped to 590 miles and the wait time to almost 14 days.
May 24, 2024
Wait times have increased at 30% of the abortion clinics in the states closest to Florida after its draconian six-week abortion ban went into effect on May 1.
The data comes from a survey carried out by Middlebury University economics professor Caitlin Myers and her undergraduate students, which was reported by The Washington Post on Friday.
"Distance and wait times are up... but telehealth is helping meet demand," Myers wrote on social media, summarizing her findings.
Suspecting that the U.S. Supreme Court would overturnRoe v. Wade in the summer of 2022, Myers began to survey abortion clinics about their wait times starting in March of that year. In her new survey tracking the impact of the Florida ban, Myers and her students called 130 clinics in Florida, Georgia, South Carolina, North Carolina, Virginia, Maryland, and Washington, D.C. They made their first round of calls last month before Florida's ban went into effect, and the next round on May 13.
Before the ban, the average Florida resident lived 20 miles from a clinic and would need to wait five days to access an abortion. After the ban, the driving distance increased by nearly 30 times to 590 miles and the wait time expanded to almost 14 days.
The Post also conducted its own analysis and found that the ban has forced around 7 million reproductive-age women in Florida and nearby states to travel farther if they need an abortion after six weeks, with the average woman now needing to drive for over seven more hours than before. The paper also found that the ban impacted a larger proportion of Black and low-income women when compared with national demographics.
Further, the Post spoke to clinic workers who detailed some of the individual stories behind the data.
Fort Lauderdale clinic director Eileen Diamond recounted the story of one woman who had traveled from Houston to Florida in search of an abortion, only learning after an 18-hour drive that Florida had passed its six-week ban. The woman, who was nine-weeks pregnant, then had to drive at least another 12 hours to Virginia and another 17 home.
"This woman was desperate," Diamond told the Post. "She had used everything she had to come to us."
Sometimes, different state restrictions can interact to make life even more difficult for those in need of abortion care. North Carolina, the closest state to Florida where abortion is legal after six weeks, requires patients to wait 72 hours between an initial consultation with a physician and the actual procedure, which puts up additional barriers for out-of-state patients. As the Post explained:
One Florida patient recently traveled 23 hours on a Greyhound bus for a consultation appointment at A Woman's Choice in Charlotte, according to Lakeynn Huffman, the clinic manager—returning home that night because she could not find childcare to cover the full 72 hours she had to wait between appointments.
The woman made the same trip two days later, Huffman said—traveling for a total of 92 hours to get an abortion.
While Florida's ban has put an additional burden on neighboring clinics, the rush has been less dramatic than after Texas passed its six-week ban in 2021. Myers explained that this is because more women are accessing abortion pills in the mail via telemedicine consultations.
However, the U.S. Supreme Court heard oral arguments last month in Food and Drug Administration v. Alliance for Hippocratic Medicine, a case brought by right-wing anti-abortion activists that seeks to restrict access to the widely used abortion pill mifepristone. The court is expected to issue a final ruling in June.
"Telehealth is really a game changer for abortion access," Myers told the Post. "But it might be a fragile one."
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To Ensure Health Equity, Congress Should Renew the Affordable Connectivity Program
As a physician delivering telemedicine-based addiction care to rural and low-income communities, the program has been the essential linchpin for creating access to lifesaving medications for opioid use disorder.
Apr 03, 2024
In an ironic twist, people recovering from opioid addiction recently gained permanently expanded access to telemedicine services through a new federal policy—but many are likely to be among the 22 million low-income households losing access to affordable internet.
The Federal Communications Commission recently began to wind down the Affordable Connectivity Program, the country’s largest, most successful internet affordability program. This government-sponsored benefit program, introduced during the pandemic, provides low-income Americans with a one-time subsidy to purchase an internet-capable device and monthly subsidies for broadband services.
As a physician delivering telemedicine-based addiction care to rural and low-income communities, the Affordable Connectivity Program has been the essential linchpin for creating telemedicine access to lifesaving medications for opioid use disorder.
I urge Congress to renew funding for the Affordable Connectivity Program and pursue legislative pathways to permanently expand internet access to all.
Substance use disorders are life-threatening chronic conditions, but they’re treatable. More than 70% of people with substance use disorders transition into recovery. However, early recovery is fragile. When people are ready to engage in care, low-barrier, rapid access to care is vitally important to support treatment success, especially during reentry from incarceration when the overdose risk is up to 129 times greater than community-based populations. Nearly half of people using opioids in rural areas were recently incarcerated, emphasizing the need for expanded rural access to treatment.
Yet, in-person addiction care is disproportionately limited in rural communities, requiring long drive times to access care. This is simply not an option for most of my patients, particularly those in early recovery. Most are trying to rebuild their lives while confronting significant financial debts incurred during past periods of expensive, prolonged substance use and incarceration. Stigma locks them out of high-earning positions, effectively segregating them to low-wage positions with limited opportunities for advancement and usually no access to benefits like paid time off to engage in care.
Many of us can get a leg up during hard times from family or peers. However, most patients in early recovery are at the starting line of repairing social relationships weakened by trust lost during active substance use and prolonged absence during incarceration. Often, the social supports they can access are facing similar resource-limited circumstances, with minimal ability or bandwidth to help with transportation or finances.
Every day, my patients choose what they can afford from a menu of necessities.
What will you have today?
- Food
- Transportation to work
- Cellphone access
- Savings toward rent
- Fees to obtain a driver’s license
Rarely can they cover more than one or two at a time. How could expensive, time-intensive travel to distant healthcare ever compete?
It shouldn’t have to. And thanks to the relaxation of telemedicine rules and the Affordable Connectivity Program, it hasn’t had to.
While the Affordable Connectivity Program’s $30 monthly subsidy sounds inconsequential, the true value of costs saved is much higher, as the collateral costs (e.g., transportation, lost-wages) of in-person services are avoided. With reliable access to data plans, my patients attend their medical appointments from their worksites during their lunch breaks or easily negotiate alternative breaks with their bosses, who are more willing to be flexible because work can quickly resume when patients remain on-site. This has allowed patients to consistently receive addiction treatment without incurring lost wages and transportation costs during the two-to-four-hour long process of in-person care. With their financial distress tempered, my patients have more quickly transitioned from survival mode to future planning.
The Affordable Connectivity Program also enabled internet access to key social resources that promote health and stability. My patients have taken online classes, searched and prepared for jobs, and built healthy social connections with online recovery communities, the latter particularly key for rural patients with limited in-person social options.
Funding for the Affordable Connectivity Program is projected to run out in April unless Congress acts quickly to renew funding. Amidst the Affordable Connectivity Program’s wind down, my team has begun switching patients to the remaining alternative telecommunication benefits for low-income households, like the Lifeline program. However, this inferior program provides only $9.95 monthly toward internet service—insufficient to cover the entire cost of a plan—and limited options of qualifying service providers. For my patients battling homelessness living in tents, cars, and motel room rentals while working tireless hours to survive and endeavor toward stable thriving, a $20 increase in monthly expenses is insurmountable.
The communities with significantly limited internet access—rural, low-income, Black—are also disproportionately impacted by the opioid crisis and low access to in-person treatment. Their precarious internet access falsely positions the internet as a luxury, rather than an essential resource for healthcare, education, employment, transportation, and social belonging. Internet access is a health equity issue.
I urge Congress to renew funding for the Affordable Connectivity Program and pursue legislative pathways to permanently expand internet access to all. Without swift action, I fear that losing the Affordable Connectivity Program will lead to more lives lost to treatable substance use disorders.
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