On March days that dawn cold and snowy, or warmer and muddy, with bad driving conditions on rural roads, meeting with a physician over the phone or video call can be especially useful for Vermonters.
“It does help with the access issues that we experience,” said Kathy Benoit, the CEO of NOTCH, a Federally Qualified Health Center serving Franklin and Grand Isle counties. “We are quite far from Burlington, here in Richford. So for some people, they're not able to get specialty care if they had to transport there.”
Of the NOTCH patients using virtual visits — not only with specialists but for follow-ups and medication checks, for annual wellness checks, for bad weather days, for appointments outside of regular business hours — Benoit said some 700 of them have Medicare as their only health insurance.
But if Congress doesn’t do anything by the end of the month, those NOTCH patients, plus thousands of other Vermonters and millions of Americans on Medicare, could lose nearly all of their coverage for telehealth visits.
“There would be no reimbursement mechanism,” Benoit said. “So that would be unfortunate.”
The current reimbursement mechanism under Medicare began during the pandemic, when the federal health insurance program for people 65 and older and for people with disabilities started offering a larger scope of telehealth coverage. Congress extended that pandemic-era coverage once already, in December 2024.
The extension, however, only lasts until March 31, 2025. That’s unless lawmakers approve a further extension — which House Republican leaders are proposing as part of a continuing resolution to fund the government through Sept. 30, 2025 — or legislation like the “CONNECT for Health Act”, which would make the expanded Medicare telehealth coverage permanent.
A spokesperson for Sen. Peter Welch wrote in an email that he would advocate for the latter bill.
Rep. Becca Balint made a similar commitment last week.
“I will work relentlessly to ensure telehealth can remain accessible for all Vermonters,” she wrote in a statement. “I understand how worried Vermonters are about their access to telehealth.”
State law requires private insurers to cover telehealth services, and Vermont Medicaid reimburses for those services, too.
Vermonters who access telehealth services through Medicare are concerned about the potential change — and are reluctant to talk about it publicly, according to Mel Houser, the executive director of All Brains Belong VT. The community health organization serves neurodivergent Vermonters, including patients who have long COVID-19, and are bedbound.
“The experience of many of our patients who depend on The System for survival — whether that be Medicare, Medicaid, SSDI, etc., is that there is a hesitancy to speak out because it does not feel safe,” Houser wrote in a text message. “The reality is that something they rely on for basic needs can be taken from them at the drop of a dime.”
Greg Marchildon, the Vermont state director for AARP, said what appears to be happening is that Medicare telehealth coverage is getting caught up in the “tidal wave of information” coming out of Washington.
“So it's troublesome and worrisome,” he said. “And we're hoping that Congress will get it together.”
House lawmakers are expected to vote on the continuing resolution bill Tuesday.
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