Telehealth on hold: Why not make telehealth flexibilities permanent?

Telehealth is popular among physicians and patients, so why not grant greater flexibility to use it in traditional Medicare, then let Medicare Advantage and private insurers follow that lead? That is not how Congress works anymore because it seldom uses the regular order of deliberation for legislation anymore. Kyle Zebley, senior vice president, public policy, of the American Telemedicine Association and executive director of ATA Action, its advocacy affiliate, explains more about procedure in the Capitol.

Medical Economics: At the risk of asking the maybe obvious question here, ATA has endorsed making permanent the telemedicine flexibilities that were allowed during the pandemic, and have that that have been extended since then. Why would that be the optimal solution?

Kyle Zebley: It's very unfortunate we haven't gotten to permanency. I think if things were operating and functioning as they should at the federal government level, we would have been made permanent long ago. That's not to knock anybody. It's a systemic issue that's built up over years, but the muscle memory of Congress is that they don't pass many standalone pieces of legislation. The legislation they do pass do not go through the so called regular order of committee consideration, markup, full consideration on a floor of either chamber, working through differences in a conference committee between the two chambers on a similar piece of legislation, then finally getting something to the president's desk into law. The regular order that I just described really no longer is able to occur. And so by muscle memory, they are, in a way, stuck to doing these big, massive bills that often come out at the last minute, that everybody in town, as in Washington, D.C., are trying to, again, catch a ride on, to be included on a policy rider. And so that's the dynamic that we've been in. We've got great permanent legislation, legislation that would make permanent these popular programs. They are extremely well supported. Indeed, the Connect for Health Act, for instance, has over six well over 60 senators as co-sponsors, 60 of the 100 senators. This is a filibuster proof majority, and yet these unfortunate dynamics that impede productivity legislatively have led us to these short-term extensions that Congress tends to unfortunately do by instinct and habit.