20/20 Vision: Legislative Foresight

While President Donald J. Trump’s campaign website has no mention of his proposed policies going forward into a theoretical second term, it does highlight what he has accomplished in his first term in a section titled “Promises Kept”. It includes mention of many Opioid Crisis-related actions as well as two that specifically addressed telehealth support or expansion:

• Department of Agriculture Provides More Than $1 Billion to Improve Access to Health Care for Rural Communities (Land and Agriculture; 11.17.17)
• President Trump and Secretary Shulkin Announce Expansion of V.A. Telehealth Services with “Anywhere to Anywhere V.A. Health Care” Initiative (Social Programs; 09.03.17)

Moving forward it is also clear that the healthcare priority for Trump’s second-term campaign will be defeating the “Medicare For All” plan that many Democrats are championing.

Visit Donald Trump’s campaign website here, and read about the rest of his “Promises Kept” here.

Bill Weld is the 74-year old former governor of Massachusetts who is also a former federal prosecutor. We could find no mention of telehealth in his official plans and issues statements.

You can read his published plans on his campaign website here.

*Joe Walsh ended his campaign in February of 2020*

Joe Walsh is a 58-year old conservative radio show host and a former congressman from Illinois. We could find no mention of telehealth in his official plans and issues statements. 

You can read his published plans on his campaign website here.

Joe R. Biden, Jr. is 77-years old. He is the former Vice President to Barack Obama and a former Senator from Delaware.

The Biden Plan for Rural America

Biden specifically mentions telehealth in the context of rural healthcare access deficits. He states that his administration would: “Expand primary care and innovative health care delivery models in rural communities by…Building new health clinics and deploying telehealth in rural America.”

His plan to do this includes expanding the funding created by the USDA Community Facility Direct Loan & Grant Program “with a focus on accelerating the deployment of telehealth for mental health and specialty care.”

Read more on Joe Biden’s plans for Rural America here.

Tulsi Gabbard is a 38-year old congresswoman from Hawaii and an Army National Guard veteran. While she has no mention of telehealth in her official vision and issues statements, she does highlight that she is one of the 32 co-sponsors of the CONNECT for Health Act. This is one of the most comprehensive telehealth-related, Medicare reform bills currently on the docket. 

Read more about Tulsi’s positions on hot-button issues here.

Read about the CONNECT for Health Act from the Center for Connected Health Policy here.

Bernie Sanders is a 78-year old senator from Vermont whose long political career includes being a congressman as well. He does mention healthcare quite a bit in his “Revitalizing Rural America” and his “High-Speed Internet for All” plans, but they are missing any specific mentions of telehealth, telemedicine, or healthcare technology.

You can read his published plans on his campaign website here.

*Michael Bennet ended his campaign in February of 2020*

Michael Bennet is a 55-year old Senator from Colorado.

Plan for High-Quality, Affordable Health Care

Under his “Medicare-X” policy, which he touts as a more realistic and affordable alternative to the “Medicare For All” plan that many Democrats support, he states his intention to “Harness technology and innovation.” He specifically mentions the benefit of our world-class level of healthcare innovation to rural communities and in closing “the urban-rural divide in access to health care.”

He also includes an actionable plan as to how a “Bennet Administration” would do that, which includes:

• “Invest in innovative care solutions, such as telemedicine and remote patient monitoring.”
  Here he defines “telemedicine” specifically as live, synchronous video and “remote patient monitoring” as the ability for a provider and patient to track “health metrics” remotely. 
• “Make a $40 billion capital investment to connect the entire country to high-speed, reliable, affordable broadband, so that rural health providers can communicate with their patients and monitor health conditions remotely through telemedicine.”

He also mentions investing in telehealth in two sub-policies titled “Improve Maternal and Infant Health Outcomes” and “Support Seniors and Caregivers.” He underlines the benefits as contributing to his plan to “reduce the risks to expectant mothers and newborns” and build on his “Independence at Home” pilot-program-turned-national-program-bill he began in 2012 and reintroduced 2017 as a Colorado Senator, which aims to help provide resources that enable seniors to “stay in their communities and still benefit from modern medicine.”

Read more on Michael Bennet’s healthcare policies here.

*Michael Bloomberg ended his campaign on Super Tuesday*

Michael Bloomberg is a 77-year old billionaire media executive and the former mayor of New York City. We could find no mention of telehealth in his official plans and issues statements. 

You can read his published plans on his campaign website here.

*Pete Buttigieg ended his campaign after the South Carolina primary*

Pete Buttigieg, a 38-year old military veteran who was the former mayor of South Bend, IN, has quite a few mentions of telehealth in his published policies.

A New Era for Health in America

In his plan for improving America’s health, Pete Buttigieg highlights how telemedicine can be used in a variety of areas towards achieving his goal of “Healing and Belonging in America.”

Mental Health and Addiction

“Increase reimbursement rates for mental health and addiction care, including care delivered through telehealth.”

Veterans Mental Health Care

Increase access to telehealth, including teletherapy and telepsychiatry, for veterans through the Connected Care pilot program.

Telehealth also fits into his goal of “Securing a Healthy Future for Rural America.” His plan outlines how he would do that in detail:

• “Massively expand coverage of high-speed broadband Internet across the country.”
• “Help health providers purchase and implement the technology necessary to provide telehealth services by doubling funding for the Federal Communication Commission’s Rural Health Care Program to $1 billion annually.”
• “Ensure that expansion of telehealth services is accompanied by investments in quality of care.”
• “Expand the types of care settings that can receive reimbursement for telehealth services.”
• “Allow health professionals to get compensated for virtually treating patients at home, including for annual wellness visits, chronic care management, acute visits, and remote patient monitoring.”
• “Make it easier for a doctor in one state to virtually treat a patient in another by amending licensure for virtual care programs.”

Maternal Health

Buttigieg also recognizes maternal health as an important issue and would address it by supporting relevant pieces of legislation that are currently under consideration: the MOMMA Act, Maternal CARE Act, MOMS Act, and MOMMIES Act. All of these bills have some mention of telehealth as a part of the solution to the high maternal mortality rate in this country.

Read more about Pete’s healthcare plan here.

*Amy Klobuchar ended her campaign the day before Super Tuesday*

Amy Klobuchar is a 59-year old senator from Minnesota and a former attorney in Hennepin County, MN. She is also one of the candidates with the most mentions of telehealth in her official policies.

She mentions it a few times in her broad issue statement on Health Care called “Turning Ideas into Action,” but those same details are outlined more fully in her individual policy plans, which she has hosted on Medium. The portions relating to telehealth in each applicable plan are highlighted below.

Veterans Healthcare

• “Expand community-based options and telehealth services, particularly in rural areas.”
  She highlights promoting telehealth services as a way to “reduce delays and expand access to care, particularly for veterans in rural areas.” (This is also mentioned in her “More Than 100 Actions for Her First 100 Days as President” plan.)

Addiction and Mental Health

• “Expand health care coverage for mental health and substance use, build a more integrated health care system, and enforce mental health parity.”
  Part of this plan includes making “major investments in increasing access to…telehealth.”

Senior Health Care

• “Strengthen Medicare and provide incentives for getting the best quality health care at the best price.”
  The first of three pieces of her plan entitled “Senator Klobuchar’s Plan for Seniors” that mention telehealth, this portion includes a statement that she will “improve Medicare for current beneficiaries by reforming payment policies” for telehealth, among other services.
• “Expand telehealth and rural health services and maintain rural hospitals.”
  In order to support seniors who want to age in place, she plans to increase access for all seniors in all parts of America. To that end, she states that “she will promote remote monitoring technology and telehealth services in Medicare and other programs that improve the quality of life and expand access to quality home care and emergency hospital services in rural areas.”
• “Support a world class long-term care workforce, increase long-term care options, and tackle disparities in long-term care.”
  Tacked on to the end of this portion on long-term care is a commitment to expanding “home care and telehealth services” for senior care.

Agricultural and Rural America

Many of the items from the previous plans are echoed in her “Plan from the Heartland: Strengthening our Agricultural and Rural Communities”, including:

• “Expanding rural health care and saving our rural hospitals”
  To do this, she states that she will both “dramatically expand telehealth services” and “reform Medicare telehealth rules that unfairly limit coverage and reimbursement.
• “Tackle rural mental health and addiction”
  This plan cites “support for clinics and community-based services, as well as technical support and telehealth services” as a way to tackle the problem of the limited mental healthcare “accessibility, availability, affordability and acceptability” in these regions.
• “Rural Veterans”
  In this last section she promises to “invest in VA telehealth services” among other ways to increase the support network for veterans living in rural areas.

Read more about where Amy stands on the issues here.

*Deval Patrick ended his campaign the day after the New Hampshire primary*

Deval Patrick is the 63-year old former governor of Massachusetts and is currently an executive at Bain Capital, a private equity firm. His Vision centers on his “The Deval for All Policy Platform,” which includes four themed “Agendas,” two of which mention telehealth.

Reform Agenda

In the portion of this section titled “Universal Access to Affordable Health Care,” he cites telehealth in two ways:

• Reduce the Cost of Care
  Part of this goal includes a promise to “Research and Innovate” by “exploring innovations like new models for community health centers, innovations in telemedicine, and other strategies to make care more local, personal and timely.”
• Ensuring Reproductive Freedom
  He promises to support reproductive health right by “support[ing] efforts to expand access to medicated abortion and telehealth options to address the lack of access to services in some states and rural areas.”

Opportunity Agenda

Here he addresses his plans for “expanding economic opportunity for every American everywhere” by focusing on the “three pillars: education, innovation, and infrastructure.” This section is mostly notable for its list of Priorities under the goal “Invest in Physical Infrastructure.” The short list includes a line-item for “Rural Hospitals and Community Health Centers,” and specifically Broadband.

Read the rest of Deval Patrick’s Vision here.

*Tom Steyer ended his campaign after the South Carolina primary*

Tom Steyer is a 62-year old billionaire and former hedge fund executive as well as a climate change and impeachment activist. His policy mentions of telehealth are below:

Health Care Policy

In his broad health care plan document titled “Right to Health Plan,” there are five pledges, one of which holds the plan’s only mention of telehealth under the section “Improve Care: The Right to Accessible, High-Quality Care.”

• He pledges to “ensure the vitality of rural and low income community health care systems by targeting additional resources to rural hospitals, encouraging community health centers, and investing in telemedicine” and “fight the opioid and mental health crisis with billions of additional dollars for new and innovative programs.”

Rural Health

His plan to support telemedicine in rural America is more fully fleshed-out in this “Partnerships with Rural Communities” plan.

Under the heading of “Investing in People”, he pledges to :

• “Prevent hospital closures by … investing in telemedicine to improve specialized care and help bridge local provider shortages.”
• “Invest $100 billion over a decade to revolutionize the way America addresses mental health care. […] Mandate that insurance programs provide full mental health coverage, increase access to telemedicine, and train additional specialized healthcare providers.”

Read more about Tom Steyer’s Policies here.

*Elizabeth Warren ended her campaign after Super Tuesday*

Elizabeth Warren is a 70-year old Senator from Massachusetts and a former Harvard professor. Her plan for Rural America details how she considers telehealth to be of benefit for this country.

In the section titled “Protecting Access to Health Care in Rural Communities” she promises:

• “I will […] establish a $25 billion dollar capital fund to support a menu of options for improving access to care in health professional shortage areas, including: […] establishing pharmacy services or a telemedicine program.”

In another section titled “Public Option for Broadband”, she details her plan for a government sponsored, funded and managed Broadband program for the whole country. She cites the following in her reasoning behind crafting such an ambitious plan:

• “One of the best tools for unlocking economic opportunity and advances in health care, like telemedicine, is access to reliable, high-speed Internet.” 

Read the rest of Elizabeth Warren’s plans here.

*Andrew Yang ended his campaign on the night before the New Hampshire primary*

Andrew Yang, is a 45-year old former tech executive who also runs an economic development nonprofit company. His policies hold the most specific mentions of telehealth over any other candidate.

In his Healthcare policies alone, there are many mentions of how telehealth fits into his plan for our nation.

Investing in Telehealth Plan

In fact, he has a portion of his plan entirely centered around telehealth.

• “Encourage the use of telehealth in rural areas and for mental health services.
• Invest into the use of telehealth in rural areas including ensuring broadband access for 99.9% of Americans. 
• Allow licensed physicians to administer medical services and medication through telehealth services. 
• Invest in the development and deployment of medical technology in rural areas to assist Nurse Practitioners and other professionals in administering vital care in areas where an MD is not physically present.
• Implement federal regulations over telehealth.
• Implement federal medical licensing to physicians to practice telehealth across state lines.”

Medicare For All

When detailing how his support for the popular “Medicare For All” plan would pan out, telehealth is featured prominently:

• “Invest in technologies to finally make health services function efficiently and reduce waste by utilizing modernized services like telehealth and assistive technology, supported by measures such as multi-state licensing laws.”

Invest in America’s Mental Health

Again in his plans for Mental Health Care, he highlights telehealth as an important part of the solution:

• “Utilize the current telehealth system to alleviate the widespread shortage of mental healthcare professionals, remove accessibility barriers caused by distance and transportation, and provide treatment from the privacy of patients’ homes.”

Fund Medical Technology Innovation

Another stand-alone section that is specifically geared towards telehealth technology, he continues his list of how we will “increase innovation with medical technology” and “promote the adoption of technology in medical uses”:

• “Promote the use of telemedicine for rural areas.
• Promote the use of AI for social workers.
• Promote the use of AI and telecounseling for those who need a psychologist.
• Create tax incentives for people to use these services.
• Look into regulations preventing the use of these technologies, especially in areas that currently require licensing.
• Invest more heavily in research on innovative medical technologies.
• Provide robust incentives via a “Race to the Top” for companies to improve health outcomes and preventative care.”

Expand Access to Medical Experts

Finally, in response to data that suggests that access to medical specialists has significant impact of quality of care and length of life, he mentions healthcare technology once again:

• “Work with licensing agencies to create new levels of medical licensure for Primary Care Specialists – technology-enabled individuals with less training than doctors to help with routine health issues while knowing when to refer a case to a Doctor of Medicine.”

Read these and the rest of Andrew Yang’s policies here.