While, broadly speaking, the bills introduced into the U.S. House of Representatives and the U.S. Senate recently—and passed by the House of Representatives—to repeal and replace the Affordable Care Act (ACA) are ostensibly focused solely on the health insurance provisions of the law, and do not touch any of the internal health system reform elements of the law, in fact, the Medicaid cuts embedded in both the bill passed by the House and the one introduced in the Senate but left unacted upon during the July 4 recess, could strongly impact one element in nationwide telehealth initiatives.
On July 3, in an article entitled “How health care bill could hurt a program beloved in Trump country,” David Pittman wrote online in POLITICO that “One of the unintended effects of the Senate’s Obamacare repeal bill would be to slash money that pays for a project popular among Republicans—using long-distance video hookups called telemedicine to connect sick kids in rural schools to big-city medical experts. In poor and rural areas, many in deep-red Trump Country, the school nurse is not just handing out bandages anymore; she’s become a de facto medical guide, marshaling medical care for poor kids with obesity, asthma and diabetes, while on the lookout for issues like child abuse and teen pregnancy.”
“In many of our situations … the school nurse is the only health care provider a child ever sees,” Kelli Marie Garber, who runs a growing school-based telemedicine program out of Charleston, South Carolina, told Pittman.
Importantly, Pittman noted, nearly half of the country’s Medicaid programs now pay for telemedicine visits, with six having authorized payment for it in the past year, according to the American Telemedicine Association. As Pittman wrote in the POLITICO article, “Telemedicine has become a powerful tool for these nurses, and Republicans like it—Health and Human Services Secretary Tom Price calls it an “exciting innovation.” But the 26 percent cut to Medicaid planned by the administration and Congress for the next decade would deplete the funds that dozens of states are drawing on to make public schools a place of healing for schoolkids.” Meanwhile, though Medicare and private payers have been very inconsistent in reimbursing for telemedicine-delivered care delivery, state Medicaid programs have been ramping up their coverage of it. “Many states have been rapidly expanding telemedicine in the schools programs, which generally serve parts of the nation where the uninsured are plentiful, health problems are grave, and school-based medical care is vital to children,” he wrote.
Healthcare Informatics will continue to update readers on developments in this area.