Telehealth lobbyists fear abortion debate could wipe out wins

POLITICO spoke to nine consultants and lobbyists who speak on behalf of clients or businesses concerned with telehealth policy, such as employers, insurance companies, service providers, healthcare systems and telehealth companies, who said abortion issues could threaten political gains. Most will only speak if they are granted anonymity due to disagreement on the matter.

While abortion services make up a small percentage of total telemedicine services, consultants and lobbyists are also concerned that digital service providers could become the next frontier in legal battles as patients in states where the procedure is illegal look for other ways to access it.

“There is a long history of abortion being a controversial element in the health insurance and funding debate, and this is likely to be even more true in the future. It will be very difficult to debate any health issue if abortion rights are not part of it,” said Larry Levitt, executive vice president of health policy at the Kaiser Family Foundation.

Relaxing the rules

The federal government has lifted dozens of restrictions on virtual visits as the country is on lockdown, with a focus on the Medicare program. Congress has extended those flexibilities for 151 days after the end of the public health emergency, which lobbyists say will happen early next year.

Lawmakers also suspended a law banning remote prescribing of controlled substances and gave employers the ability to offer pre-deductible telemedicine services to people with high-deductible health insurance plans that expire at the end of the public health emergency and in December. . 31 respectively.

The race is on to pressure Congress to expand these policies, which have been beneficial to providers and telehealth companies, making it all the more important to avoid thorny questions about reproductive rights.

“We’re not letting off the gas pedal,” said Elyse Shuman, senior vice president of health policy at the American Board of Benefits, of the group’s intense lobbying efforts to expand provisions related to telemedicine coverage to those with health care plans. high deductible insurance. . But its members did not talk about abortion.

“Employers are just trying to… understand and understand the consequences Dobsshe said, meaning Dobbs vs. Jackson Women’s Health Organizationrecent decision that reversed Caviar. “A lot of people are just trying to figure out what this really means for their policies and benefit plans. A lot more questions and answers could come out of this in the coming weeks or months.”

The pandemic has been a boon for those offering telemedicine services, including the emergence of new telemedicine companies and a wide expansion of vendor offerings due to growing demand from patients. Although studies have shown that the use of telemedicine has stabilized, it is still many times higher than pre-pandemic levels.

Republican health lobbyist said key lawmakers from both parties Leading telemedicine flexibility efforts are also reluctant to get drawn into the abortion debate because they also focus on the benefits of broader telehealth policy goals. Since there is already a legislative framework – and momentum – to expand existing flexibilities, the inclusion of abortion could jeopardize these bipartisan negotiations.

While there may be politicians, both progressive and conservative, who want to use telehealth provisions to address abortion at the federal level, “the people who are in the telemedicine compromise room will not be interested in discussing this question”. said.

“Not a dispute about merit”

However, companies or providers involved in telemedicine may not be able to avoid the issue of abortion for long as states take steps to protect or ban the procedure while updating their telemedicine laws.

“If you help a client, you tell him: “First, it is not clear whether you can avoid this. Absolutely incomprehensible. Because the minute it’s brought up in debate, it’s all over.” So keeping quiet about something in a negotiation isn’t necessarily going to work,” said the 20-year veteran of the healthcare consulting industry, who has been given the anonymous right to speak about client issues.

States that ban abortion don’t make exceptions if the doctor is in another state, so some people may find it easier make an appointment for telemedicine in an abortion-friendly state than to find a physical clinic. Already been surge in demand to get abortion medication online.

“This is not a debate about the merits of telehealth. Everyone recognizes that telemedicine is expanding access to healthcare services, whether it be chronic care, mental health, emergency care, primary care, specialized consultations or other services,” said Krista Drobak, Executive Director of Alliance for Connected Care, a coalition of companies and providers working to expand the flexibility of telemedicine. “This is a debate about upholding standards of care set by the state. Health care professionals have always been and will always be required to comply with the laws and standards of care set by the state in which the patient is located, regardless of where the provider is located.”

Telemedicine advocates have long had to balance reproductive rights with access to telemedicine.

One political consultant who works with telemedicine companies noted that states like Arizona and Florida, which she says have “really great” telemedicine policies, including license waivers and preferential insurance provisions, have also moved to ban abortions. This is an example of the tension that exists for those in the telemedicine field as they try to balance their views on abortion with the desire to promote policies that expand telehealth.

“The fight for the people who consult in this space is that it is a difficult needle because there are other critical healthcare services – [medication-assisted treatment], contraceptive services. There are so many contraceptive deserts in Texas where telemedicine has been a game changer,” she added. “It’s a balance, it’s a tension that many of us had before this decision. And the question is, what now, huh?