We know telehealth is safe, effective and in demand … so why are some states creating significant barriers to care, or even eliminating telehealth completely?
Getting telehealth off the ground was an uphill battle: “We don’t need it.” “Patients won’t use it.” Or even, “the laws don’t allow it.” Then the pandemic hit, and access to healthcare via telemedicine exploded. Suddenly, people were receiving care from home, freeing up in-person appointments for those who truly needed them. Regulatory barriers were lifted, allowing healthcare providers to treat patients remotely. The research shows it worked—and that people embraced it.
Now, telehealth is driving access to abortion care in an increasingly restricted environment. It also has the potential to revolutionize OB-GYN care, expanding access to services like prenatal checkups and postpartum care for millions—especially those in maternity care deserts.
An overwhelming amount of research has shown that telehealth for medication abortion care is just as safe and effective as in-person care. Expanded options for telehealth are currently being utilized, motivated by shield laws in some states, that create protections for providers who choose to use telehealth to treat patients in states with abortion bans or restrictions on telehealth usage. These laws were passed in response to the shuttering of clinics, increased barriers and ongoing patient need for abortion care.
The latest #WeCount data from the Society of Family Planning shows that telehealth now accounts for 20 percent of all abortions in the country, propelling the increase in care in the United States.
So, if we know that telehealth is safe, effective and in demand, why are some states creating significant barriers to care or even eliminating telehealth completely?
While many state and federal telehealth policies from the pandemic that streamlined care were made permanent, some states enacted medically unnecessary and cumbersome restrictions. These regulatory roadblocks disproportionately impact patients living in states with abortion bans, sometimes forcing people to either cross state lines to seek care or to forego it altogether. These restrictive policy include requiring a video component as part of a care visit, prohibiting asynchronous or audio-only care (commonly referred to as phone calls or messaging services), or returning to strict provider licensure requirements that restrict patients choice of provider, even if life- or health-saving care is unavailable close to home.
Given the increase in provider shortages and care deserts in the maternal health space and the lack of broadband access in rural and urban area, it’s time to demand more than the status quo when so many people lack access to needed and urgent care.
In the wake of Dobbs, the patchwork of state laws has created chaos, confusion and crisis that would not be eliminated, but can be reduced through telehealth—should policy stop getting in the way.
States must eliminate requirements for in-person visits when they are not clinically necessary and instead allow all-virtual visits, especially for medication abortion care and routine OB-GYN care.
States could also adopt policies that allow nurse practitioners and other non-physician providers to practice at the top of their license, further expanding the provider network available to deliver care via telehealth.
States must also expand Medicaid coverage to include telehealth for medication abortion care and other gynecological services, ensuring that people struggling to make ends meet can access affordable services.
Finally, payment parity laws should be enacted to ensure providers receive fair reimbursement for telehealth services, removing the financial disincentives that discourage providers from offering virtual care.
It’s time to return to the promise of telehealth and think expansively about all the ways that it can revolutionize care. Our country should be one where a high-risk pregnant person, whose closest hospital birthing unit is hours away in the next state over, wouldn’t have to travel hours several times a month for checkups. Our society can be one where someone seeking an abortion but living in a state that bans providers from offering care could connect with a clinic in a different state. The pandemic showed us how we can quickly pivot to meet patient needs, and we should look to those examples to guide us moving forward.
Instead of implementing policies that create barriers, we should instead be asking: In this age of innovation, how do we let providers practice medicine and patients receive care in ways that work best for all?
The time is now to take practical measures to move the entire field forward to ensure everyone has equitable access to the care that is needed.
Getting care via telehealth should not depend on the state you live in. It should depend on the care that is needed.
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