Will telemedicine for seniors survive federal budget battle? Here’s what we’ve learned
Update March 18: Telehealth waivers were extended for six months through Sept. 30 with the passage of a short-term federal government funding bill, signed over the weekend by President Trump.
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Is telemedicine going away for seniors? Not exactly, but retaining the current standard of access is dependent on federal action in March.
Postings via social media have amped up concerns over a deadline to extend waivers for Medicare that include, among other features, allowing telemedicine access from the comfort of one’s home. Those waivers are part of the March federal budget battle.
Failure to extend would see the program revert to an earlier version with more point of access restrictions.
If that sounds familiar, it’s because the telehealth waivers were previously at risk of expiring as recently in December before Congress renewed them for three months.
Kyle Zebley is senior vice president, public policy, with the D.C.-based American Telemedicine Association and executive director of ATA Action. In a statement published Feb. 21 on ATA’s website, Zebley stated that, “Our conversations on Capitol Hill confirm that President Trump and his team are actively working with Congress to extend vital telehealth flexibilities beyond the looming March 31, 2025, deadline.”
He added that ATA is urging the administration and Congress “to make telehealth flexibilities permanent or extend them for as long as possible. Medicare beneficiaries deserve access to care that is convenient, effective, and uninterrupted.”
Some note it’s not exactly a done deal, given the current cost-cutting framework for federal spending.
In July 2024, the Congressional Budget Office estimated a two-year telehealth extension would cost the U.S. government around $4 billion.
“If the only issues at debate were extension of the telemedicine waivers, I think there’s a very good likelihood of extension because it is a bipartisan issue,” said Ian Goodhew, associate vice president for external relations at UW Medicine in Seattle.
“You have members of Congress on both sides of the aisle that think access via telemedicine is a good thing,” he added.
Efforts to make the waivers permanent have yet to succeed.
Since COVID, Goodhew noted, efforts to extend the COVID-era waivers around telemedicine “have been wrapped up in the federal budget process. ... in December, we heard there was an agreement to extend the waivers by a year, then it was five years, then it was two years.”
Ultimately they were approved for three months.
While technically the waivers are in place through the end of March, there also is an earlier overall federal budget deadline, tied to a looming government shutdown if Congress does not pass a spending bill before federal funding runs out on March 14.
How we got here
Telemedicine waivers under the American Relief Act received a three-month extension of what’s known as “telehealth flexibilities” (through March 31, 2025). Among other things, it allows patients to participate in their online or audio medical session from home.
That stood in contrast to an earlier incarnation of telemedicine years before, which sent patients to an official medical establishment to participate in a session at that site, among other restrictions.
The waivers expanded the reach of health care, tied to Medicare reimbursements for providers.
Goodhew of UW serves as the system’s lead lobbyist and has worked on telemedicine policy at the state and federal level for more than a decade.
He recently spoke to The News Tribune in response to questions about telemedicine’s evolution since access restrictions were first waived in March 2020.
“One of the silver linings out of the pandemic was that at the federal level, particularly right around Medicare, there were a lot of waivers put into place around telemedicine requirements and allowing patients who are on Medicare or some type of Medicare Advantage plan to receive care via telemedicine,” he said.
“And of course, the reason was we were all supposed to be staying home and minimizing social contact.”
He explained that when telemedicine began, patients “essentially couldn’t be at their home to do the telemedicine visit. They had to go to a health clinic to then do a telemedicine visit with the doctor, which kind of defeated the purpose,” he said.
It was still valuable in some cases, he noted.
“A lot of times, people were getting access to specialists that were not at their local clinic,” he said. “So someone living in Wenatchee maybe had to go to a health clinic in Wenatchee, but they could talk to a dermatologist or a cardiologist in Seattle that they otherwise wouldn’t have access to.”
“But it was clunky,” he added.
If the waivers are not extended, those old rules would come back into play.
For now the expiration of waivers appears to only pose a potential issue for Medicare patients.
Michael Connors, media representative for Providence, told The News Tribune via email in response to questions, “For patients outside of Medicare, Washington has laws in place that allow for telehealth to continue for other patients including Medicaid.”
Connors added, “Providence is proud to have supported these policies to ensure access to care for patients via telehealth.”
Tacoma-based MultiCare, in a statement, told The News Tribune that it is working with “Washington state’s federal delegation to ensure that reimbursement for telehealth services remains a viable option for all our patients.”
It noted, “Since the COVID-19 pandemic, telehealth has become an important service for many of our patients, particularly those who have difficulty getting to in-person appointments.”
It added that the health system “will continue to advocate for the importance of these services in the coming weeks, in the hope that Congress will recognize their value and provide funding.”
Representatives for Virginia Mason Franciscan Health and Kaiser Permanente did not offer responses to requests for comment regarding the telemedicine issue.
“It’s definitely a big budget decision about whether to continue to pay for this much access for Medicare-insured patients,” said Goodhew, “but the question always is, if you’re providing good preventative care, is it worth it?”
He then answered his own question.
“People have found it to be convenient but most importantly, very effective in terms of them maintaining their health. ... Providers and insurance companies don’t always agree on things, but I think this is one area where we definitely agree it’s good for patient access.”
This story was originally published February 28, 2025 at 5:30 AM.
