Lobbyists pressuring Congress on telehealth issues are staying away from abortion matters because they don’t want to jeopardize their chances of extending the pandemic-related rules that have been a boon to the sector, several of them told AWN.
The industry consultants and advocates are continuing their approach — even after the Supreme Court ruling overturning Roe v. Wade — because they don’t want to derail their congressional legislative goals to expand access to virtual care or weaken a coalition they’ve built over the last two years.
Eased as a response to the Covid-19 pandemic, the telehealth rules are widely popular and wouldn’t involve abortion care as a vast majority apply to the Medicare program. But advocates fear that abortion politics could find a way into their negotiations to extend the relaxed rules that are tied to the public health emergency — which could end as early as October, though the Biden administration is likely to extend it beyond that date.
“The telehealth industry and telehealth advocates want to maintain our bipartisan support, and this obviously complicates that,” one advocate for the telehealth industry said of the Roe decision. “We, as an industry, are just trying to make as many gains as we can, however we can, while maintaining that bipartisan support and bipartisan credibility.”
“If you were to go all-in on this issue or even really take a strong position on teleabortion, you risk offending significant numbers of policymakers whose support you hope to have in future, so it’s a very fine line,” added the telehealth industry lobbyist, who was granted anonymity to freely share his thoughts, referring to both political parties. “It definitely brings a lot of consternation, a lot of concern.”
AWN spoke with nine consultants and lobbyists who advocate on behalf of clients or businesses that care about telehealth policy — such as employers, insurers, providers, health systems and the telehealth companies — who said that abortion issues could threaten policy wins. Most would speak only if granted anonymity because of the divisive nature of the issue.
Although abortion services represent a small percentage of overall telehealth services, consultants and lobbyists are also concerned that digital providers could become the next frontier in legal battles, as patients in states where the procedure is illegal seek other ways to access it.
“There’s a long history of abortion being a contentious element of debates over health care coverage and financing, and that’s likely to be even more true going forward. It’s going to be very hard to have a debate about any health care issue without abortion rights being a part of it,” said Larry Levitt, the executive vice president for health policy at the Kaiser Family Foundation.
Easing of rules
The federal government waived dozens of care restrictions for virtual visits as the country locked down with a particular focus on the Medicare program, such as allowing providers to be reimbursed for telehealth care versus in-person visits. Congress has extended these flexibilities for 151 days after the public health emergency ends — which lobbyists think will be early next year.
Lawmakers also suspended a law that prohibits controlled substances from being prescribed remotely, and gave employers the option of offering pre-deductible coverage of telehealth services for people with high-deductible health plans — these expire at the end of the public health emergency and on Dec. 31, respectively.
The race is on to keep pressure on Congress to extend these policies, which have been beneficial for providers and telehealth companies — making it even more important to avoid thorny questions about reproductive rights.
“We are not letting our foot off the gas,” said Ilyse Schuman, the senior vice president of health policy at the American Benefits Council, of the group’s intense lobbying efforts to extend the provisions related to telehealth coverage for those in high-deductible health plans. But its members haven’t been talking about abortion.
“Employers are just trying to … grapple and understand the implications of Dobbs,” she said, referring to Dobbs v. Jackson Women’s Health Organization, the recent decision that overturned Roe. “A lot of folks are just trying to figure out what this really means for their policies and for their benefit plans. There might be a lot more questions and answers that emerge from that in the weeks or months to come.”
The pandemic has been a boon for those offering telehealth services, including the emergence of new telehealth companies and a broad expansion of offerings from providers due to swelling patient demand. Although studies have shown that telehealth usage has plateaued, it’s still many times higher than pre-pandemic levels.
A Republican health care lobbyist said that key lawmakers from both parties leading the effort to extend telehealth flexibilities don’t want to get pulled into the abortion debate, either, because they’re also focused on the benefits of the larger goals of telehealth policy. Since there is already legislative framework — and momentum — to extend the existing flexibilities, bringing abortion into the mix could threaten those bipartisan negotiations.
While there may be policymakers, both progressive and conservative, who want to use telehealth provisions to address abortion federally, “the folks that are in the room negotiating the telehealth compromise are not going to be interested in introducing this issue into the conversation,” she said.