Potential telehealth cuts under Trump: What providers need to know

Telehealth has revolutionized healthcare delivery in the United States, providing critical access to care — especially during the COVID-19 pandemic. But the long-term future of telehealth for certain providers and patients remains uncertain in the face of telehealth policy changes in 2025. 

While some telehealth flexibilities created during the acute phase of the pandemic have since become permanent, some still operate temporarily, such as the Medicare telehealth flexibilities. These extensions previously would have expired at the end of March 2025, but President Donald Trump signed a funding bill pushing the date to September 30, 2025.

As the September 30, 2025 deadline for the expiration of telehealth flexibilities inches closer, many providers are unprepared for what may lie ahead. Seventy-one percent of healthcare providers say they are only somewhat prepared or not at all prepared for the flexibilities to expire, with 84% noting that their compliance and IT teams do not have formal response plans. Only eight percent said staff had been trained or briefed on the upcoming changes.

Here’s how providers and patients can adapt if telehealth extensions cease. 

On June 26, 2025, Representatives Mike Thompson (D-CA), Doris Matsui (D-CA), David Schweikert (R-AZ), and Troy Balderson (R-OH) introduced H.R. 4206 (CONNECT for Health Act 2025) that would make telehealth flexibilities permanent. CMS, medical groups, and others are actively urging Congress to pass the bill.

In the meantime, medical practices must prepare for a scenario in which telehealth flexibilities are not extended beyond the deadline. Here are some key proactive steps to take now:

The best strategy? Hope for extension but prepare for expiration. Tighten workflows, educate staff and patients, and monitor legislative developments daily.

In response to the COVID-19 pandemic, the federal government used section 1135 of the Social Security Act to grant Medicare and Medicaid emergency flexibilities to significantly expand telehealth coverage.

Some of the telehealth policies include:

The government has extended the expanded telehealth coverage multiple times, and has now set the most recent extension to expire on September 30, 2025. It has already eliminated some services, such as remote cardiac and pulmonary rehabilitation, while allowing others, like virtual mental health visits, to remain through the extension period.

Here are some potential telehealth restrictions that could go into effect.

One unresolved issue is whether patients can still see out-of-state providers who are not licensed where they reside. 

During the start of the pandemic, many states temporarily relaxed rules around this. But state licensing restrictions are starting to creep back — which can impact patients who have moved or travel frequently. 

“This is a big problem and concern. I can’t see a patient in New Jersey just 45 minutes away, but I can see a patient in Long Island who is 2 hours away from the office or someone in western NY who is 6 hours away,” Dr. Stella Bard, an ABMS board-certified rheumatologist who currently practices in New York and Texas, says. 

As state regulations are in flux, check with the appropriate state agency directly for the most recent updates. The Center for Connected Health Policy also provides an informational-only list of cross-state licensing requirements. 

The Drug Enforcement Administration (DEA) has proposed new rules regarding remote prescribing:

These are proposed rules and have not been finalized.

Several factors are driving these potential telehealth changes. Policymakers cite concerns over cost containment and fraud prevention. They claim that the rapid expansion of telehealth has led to increased healthcare expenditures and potential billing abuses. There is also a push to return to pre-pandemic healthcare policies, with some lawmakers advocating to reinstate traditional in-person care models. 

Others worry that telehealth may be overused and should be limited to specific cases rather than serving as a widespread replacement for in-person visits. While these arguments carry weight, the consequences for patient access and provider sustainability remain a pressing concern.

“What about disabled people and their mobility issues preventing them from showing up in person, and older people and theirs, and those who are immunocompromised and risk catching a bad infection or virus both in transit and in office from other patients?” Dr. Bard notes. “Our most vulnerable patients will have their only access to care removed.”

Not all telehealth services are being treated equally. Back in December 2020, Congress made Medicare coverage of remote behavioral health services permanent.

Meanwhile, other specialties like rehabilitation, dermatology, and chronic disease management may see a more fragmented approach. In these cases, coverage might be determined state by state or even payer by payer. 

This patchwork of policies will require providers to stay constantly informed and act quickly to decide how they should best structure their services. “This is a huge, unreasonable burden on providers, as we are one and the insurance companies outnumber us,” Dr. Bard says.

The potential telehealth policy cuts could have a large impact on both patients and healthcare providers.

Many people who are older, are low-income, have mobility issues, or live in rural or underserved areas may face new challenges in accessing virtual care if the government reduces telehealth coverage. Patients who previously relied on remote consultations could experience care disruptions, and in turn, worse health outcomes. 

“I work closely with such populations and arranging transportation, even for those who are eligible where it is completely covered by their insurance in full, is still a tremendous challenge. Most have no choice but to miss their appointment when transportation doesn’t show up even after it’s arranged,” Dr. Bard says.

Those without reliable internet can access audio-only telehealth visits for behavioral/mental health services permanently, and for non-behavioral/mental health services through September 30, 2025. After that date, without further telehealth policy changes in 2025, audio-only options will remain available only for those who cannot use or do not consent to video technology.

This potential reduced Medicare coverage could also have a cascading effect — leading to private insurers also rolling back telehealth coverage.

While these potential cuts could present challenges, telehealth is unlikely to disappear entirely. 

Moving forward, there may be opportunities for bipartisan support on maintaining some level of telehealth flexibility, particularly for rural and underserved populations. Additionally, advancements in technology and increasing patient demand could drive private insurers and states to expand telehealth coverage, even as federal policies shift. 

Emerging technologies such as remote monitoring devices, AI-assisted diagnostics, and secure patient portals could help extend the reach of virtual care while meeting stricter compliance requirements. “We have the technology, so why not use it to provide care?” Dr. Bard says.

Likewise, collaborations between independent providers and larger health systems or telehealth platforms may provide shared resources and scale needed to survive in this changing environment.

Telehealth’s rapid expansion during the acute phase of the COVID-19 pandemic reshaped healthcare delivery, but potential policy reversals under Trump in 2025 are now challenging its future. While cost concerns and fraud prevention drive these decisions, the impact on patient access and provider sustainability cannot be ignored.

Independent practices will need to find innovative ways to integrate virtual care within a possibly new regulatory framework to continue serving their patients effectively.