While lobbyists are supplicating President Donald Trump and the Republican-led Congress to continue their leadership on telehealth and extend expiring flexibilities—which Trump began during the COVID-19 pandemic—they no longer are asking for a concrete timeline.
Three hundred and fifty organizations signed a letter to congressional leadership Monday urging lawmakers to extend expiring Medicare telehealth flexibilities and to restore telehealth access lost by commercially insured patients in December.
The organizations told Congress that they prefer to make the telehealth flexibilities permanent. However, in a messaging shift, the groups said they “recognize this could be a multi-year process” and asked Congress to consider a "long-term" extension.
Lobbyists told Fierce Healthcare they are uncertain for how long Congress may extend Medicare telehealth flexibilities. The messaging breaks from last year’s pleas to Congress that centered on either permanency or a two-year extension, based on bills in the House.
“We are very much subject to the larger conversation,” Chris Adamec, executive director of the Alliance for Connected Care, explained in an interview. The biggest factor is Congress’s March 14 funding deadline.
The letter was spearheaded by virtual care advocacy groups including the American Telemedicine Association (ATA) and the Alliance for Connected Care. It comes as Congress faces a March 31 deadline for a slew of healthcare programs it extended for 90 days at the end of 2024.
The organizations seek to give their members, patients and providers certainty about continuing Medicare telehealth services and allow businesses to continue investing in virtual care infrastructure, including flexible staffing options enabled by telehealth.
“This is a really popular bipartisan measure that all started by President Trump five years ago. And we're hopeful that he will be very supportive of however it happens,” Kyle Zebley, executive director of the ATA’s lobbying arm, ATA Action, told Fierce Healthcare.
Not only did the Trump administration ignite the virtual care flexibilities that patients and businesses have been relying on for the last five years, virtual care is also paramount for HHS Secretary Robert F. Kennedy Jr. to tackle chronic disease, Adamec said in an interview.
“If Congress were to fail to extend telehealth, they would be shooting the administration in the foot and their efforts to address chronic disease and scale highly efficient interventions,” Adamec said.
The major dynamic in play is how Congress navigates the March 14 government funding deadline. It’s possible that a telehealth extension could be included in the funding bill, which Zebley assumes will be the vehicle. It’s also possible that Congress doesn’t include telehealth and uses its built-in 17-day buffer to work on expiring health policies.
A telehealth extension is likely, the two lobbyists said. They’ve separately received verbal commitments from House and Senate offices that telehealth will not be allowed to lapse on March 31. But there is not yet bill text that specifies what policies are in and for how long Congress plans to fund them.
“We have gotten an indication from all the right folks, both Republicans and Democrats, and there's been great indications from President Trump that the telehealth flexibilities are not going to be allowed to expire past the end of next month,” Zebley said. “How that will be accomplished remains to be seen.”
The organizations also call on Congress to address a provision that expired at the end of 2024, which guaranteed first-dollar coverage of telehealth for patients with high deductible health plans linked to health savings accounts. The extra coverage of telehealth services for commercially insured patients in the biggest plan group has not been active in 2025.
Congress could do another short-term continuing resolution, like it resorted to at the end of December, when then-President-elect Donald Trump inserted himself into Congress’ annual budgeting process and nixed a deal that extended telehealth for two years over spending concerns.
The worst case for telehealth is a short-term funding patch that punts the issue to later in the year, Adamec said.
Zebley said the ATA would like to see a package consistent with the one presented at the end of December, which had been negotiated by both parties. It included a two-year extension for Medicare telehealth and a five-year extension for the Centers for Medicare & Medicaid Services' Hospital at Home program. The ATA is also pushing for virtual diabetes prevention program suppliers in the Medicare Diabetes Prevention Program, expanded access for tele-mental healthcare and fewer limits on the remote prescribing of controlled substances.
Zebley noted that the telehealth community ranges from the largest hospitals in the nation to individual providers.
“The holy hell that will emerge from voices that are disparate and across the country, but will be great in multitude, will be so pitched that I think it would be a matter of a few days, maybe hours, in terms of when Congress would rectify that unfortunate oversight,” Zebley predicted.