Telehealth faces a looming deadline in Washington | Healthy Bottom Line podcast

Telehealth advocates find themselves in a familiar position.

Kyle Zebley of the American Telemedicine Association talks about pushing for telehealth reforms in the latest episode of Healthy Bottom Line, a podcast from Chief Healthcare Executive.

The federal government waivers for telehealth programs, including hospital-at-home programs, are set to expire soon.

When Congress passed a short-term spending package in December to keep the government running, lawmakers only extended the waivers through the end of March. So as Congress gets set to work on another broad spending package, including a host of healthcare priorities, advocates are pushing for telehealth extensions.

Kyle Zebley, vice president of public policy for the American Telemedicine Association, talked about the push for telehealth in Washington in the latest episode of Healthy Bottom Line, a podcast from Chief Healthcare Executive®.

“This is something that the telehealth community has gotten used to, and while we're not happy about it, per se, it is just a fact of life. And I think it's emblematic of how Washington, D.C. now operates,” Zebley says.

In the podcast, Zebley talks about the urgency to secure another extension of telehealth programs. Zebley and telehealth programs would like to win approval for permanent reforms, but they’re hoping to get the longest extension possible.

In December, Congress was on the cusp of a multi-year extension for virtual care programs, including a two-year extension for telehealth programs. Lawmakers had also agreed to a five-year extension for hospital-at-home programs, to the delight of health systems. But President Trump and Elon Musk scoffed at the large spending bill, for reasons having nothing to do with telehealth, Zebley notes.

With the pressure to get a short-term spending package done, Congress offered an extension on telehealth programs through March. But the short-term spending package only covers most government programs through mid-March, so as Zebley notes, the clock is ticking.

“Our bottom line message to our allies on Capitol Hill, our great ally in the Trump administration, and the key personnel that our staff in that administration, is, please give us the longest extension possible, if we're not going to get permanency, in order to allow for planning for providers and patients alike,” Zebley said. “But we’ll see what happens.”

Zebley says Trump has been a supporter of telehealth, noting that he helped engineer relaxed rules for telehealth programs during the emergence of the COVID-19 pandemic.

“All these things were put in place by President Trump, either through unilateral executive action or through work in collaboration with the Congress on a bipartisan basis,” Trump says.

Hospitals and health systems have also been pressing lawmakers to approve long-term extensions for telehealth.

At a time when the partisan divide has perhaps never been wider, Republicans and Democrats have also supported telehealth programs, Zebley says. Lawmakers and President Biden’s administration brokered a two-year extension in 2022, carrying the flexibilities through 2024.

Zebley said the fact that lawmakers approved another extension, even a short one going into the spring, indicates that Congress backs telehealth programs.

Even with the delays in securing another long-term extension for telehealth, Zebley says support hasn’t diminished in Congress.

“I think it's a sign of our great bipartisan champions and support that we weren't left out entirely in a ruthless exercise where key congressional leadership and staff had to really work to slim it down, to find a way to get passed in both chambers,” he says.

But he says securing another extension can’t be taken for granted due to the partisan divides in Congress, and lawmakers generally waiting until the last minute to come together on spending bills.

“Again, there's a lot of signs of support for telehealth on a bipartisan basis,” Zebley says. “So what are our big obstacles if we've got such bipartisan, broad-based support? I think the biggest obstacle is the dysfunctionality of Congress and how we administer government at the federal level here in Washington, D.C. That's knocking nobody. It's knocking everybody.”

During a wide-ranging discussion, Zebley talked more about the landscape in Washington with the Trump administration and Congress, other key priorities in the coming year, and securing approval for remote prescription of certain drugs.

Zebley touts the importance of telehealth in rural areas, where access to physicians can be difficult, and in urban areas.

“It's really important to emphasize that I think one of the great myths that existed prior to the onset of the pandemic, that was busted by the pandemic, was the idea that this would be a rural-only tool, telehealth in general. And that's just not proven to be the case. There's lots of reasons for both, flexibility for access, for the ease in making adjustments to your everyday life, that suburban and urban Americans have greatly benefited from increased access to telehealth as well,” Zebley says.

Check out the full conversation.