Telemedicine, clinical and non-clinical health care delivered remotely through computers and mobile devices, is helping millions of Americans – especially those who do not have access to medical facilities – stay healthy and enjoy quality health care during the coronavirus pandemic to obtain. .
In March, the Centers for Medicare and Medicaid Services (CMS) temporarily expanded Medicare coverage for telemedicine visits to allow more Americans to access health care from their homes without exposing themselves or others to the risk of COVID-19. Although co-insurance costs and deductibles continue to apply, many private insurers have chosen to waive or reduce these fees.
By April of this year, nearly half of all visits to Medicare primary care were through telehealth. In June, a HealthyWomen survey of how women were affected by the pandemic found similar results – half of our respondents who were able to get medical care did so through telemedicine.
Although many millions of people rely on telemedicine services, as of October 1, many telemedicine services either expired or were reset by private insurers. For example, UnitedHealthcare, Anthem and Aetna decided to either end free coverage or waive the cost of copays and deductibles for non-COVID-19 telemedicine visits for privately insured members.
These insurers will continue to waive telemedicine costs for Medicaid and Medicare Advantage patients through 2021. However, these changes are already affecting healthcare decisions. Make no mistake: whether now or months from now, ending free coverage or being able to use telemedicine is going to prevent many people from getting the quality health care they need.
In my view of over 25 years of legislative advocacy and political work by the federal and state governments within the insurance industry and business associations, the federal government and several non-profit organizations, as well as currently as a senior political advisor at HealthyWomen, it does not make sense to go in this direction. Instead of pushing back on telemedicine, we need to discuss whether the temporary extension of Medicare coverage for telemedicine visits should be made permanent.
Who will suffer most when they end free telehealth insurance?
The differences in health care and health insurance precede the pandemic, especially among women and minorities. For example, the United States is one of the few comparably affluent countries where maternal morbidity and mortality has tended to deteriorate rather than improve in recent decades. This is especially true for black women, who suffer from such high levels of maternal mortality and morbidity that the problem is a public health crisis.
Race isn’t the only contributing factor to differences – a lack of maternal fetal medicine (MFM) and an unequal distribution of providers mean that rural women have no access to care from maternal fetal medicine specialists (98%) the MFM providers were in urban areas).
And more than 46 million Americans who live in rural areas are at higher risk of dying from heart disease, cancer, stroke, and chronic lower respiratory diseases than people who live in cities. Rural communities also have older populations with high rates of pre-existing health conditions.
The Affordable Care Act (ACA), which was incorporated into law in 2010, removed some barriers to care by expanding Medicaid eligibility and forcing insurers to accept most applicants, including those with pre-existing conditions. Coverage rates for all racial and ethnic groups rose under the ACA, and the largest gains in coverage were for underinsured groups, including Spanish, Black, Asian, Native American and Alaskan people.
Nonetheless, differences in health care across racial, ethnic, geographic and economic boundaries persist, especially among women and especially among minority women. Telehealth has helped fill in some of the gaps by addressing certain differences.
The legislature must make telehealth a central political issue
More people have died from COVID-19 in the United States than in any other country. This makes it clear that the pandemic in our country is not only a health crisis, but also a stress test that has revealed systemic problems in our health system.
The Coronavirus Aid, Aid and Economic Security Act (CARES), which Congress passed with strong support from both parties, was central to encouraging CMS to temporarily improve access to telemedicine during COVID-19. The CMS temporary waiver and insurers’ decision to waive or reduce fees were a step in the right direction as they not only encouraged the public to stay home at a time when social distancing was crucial Important, but also contributed to improving the care of rural and other medically underserved populations.
It is time for Congress to review and revise the telehealth rules. This will modernize our healthcare systems so that as many people as possible can continue to receive the healthcare they need in a safe and effective manner.