California's Medical Licensing Law Challenged: A Legal Battle Over Telehealth Access
In a recent court ruling, the United States District Court for the Eastern District of California dismissed a constitutional challenge against the state’s medical licensing requirements. The lawsuit, brought by Dr. Sean McBride and patient G. Shellye Horowitz, sought to challenge California’s mandate that all doctors treating patients in the state—whether in person or via telehealth—must obtain a California medical license.
The Legal Challenge
Plaintiffs argued that the state’s licensing laws violate multiple constitutional provisions, including the Commerce Clause, the Privileges and Immunities Clause, and the First Amendment. Specifically, they contended that California’s licensing requirement imposes excessive burdens on out-of-state physicians and limits patients’ access to specialized medical care.
”…they contended that California’s licensing requirement imposes excessive burdens on out-of-state physicians and limits patients’ access to specialized medical care.”
Horowitz, a California resident with hemophilia A, highlighted the difficulties she faces in accessing specialized care. She currently receives treatment from specialists in Portland, Oregon, but is unable to engage in telehealth consultations with them without those doctors obtaining California licenses. Similarly, Dr. McBride, an oncologist based in New York, treats patients from across the country, but is restricted from providing remote follow-up care to his California patients without an in-state license.
The Court’s Rationale
The court dismissed the lawsuit, but allowed the plaintiffs an opportunity to amend their complaint. In its ruling, the court emphasized that California’s licensing laws apply equally to all physicians, regardless of their residence. “California’s licensing rules are the same for all doctors, no matter where they live,” the decision stated. “All doctors must obtain a license from the state’s medical board before they treat California patients.”
“California’s licensing rules are the same for all doctors, no matter where they live,” the decision stated.
The court found that the licensing requirement does not unlawfully discriminate against out-of-state doctors or excessively burden interstate commerce, a key claim under the Commerce Clause. It noted that similar regulations in other professions, such as state bar admissions for lawyers, have been upheld in past cases. “The mere fact that a firm engaged in interstate commerce will face increased costs as a result of complying with state regulations does not, on its own, suffice to establish a substantial burden on interstate commerce,” the ruling stated.
“The mere fact that a firm engaged in interstate commerce will face increased costs as a result of complying with state regulations does not, on its own, suffice to establish a substantial burden on interstate commerce,” the ruling stated.”
First Amendment Concerns
The plaintiffs also argued that the law unconstitutionally restricts speech by preventing doctors from communicating with patients about their medical care. The court rejected this claim, clarifying that California’s licensing rules regulate professional conduct rather than free speech. “States do not lose the power to regulate the safety of medical treatments merely because those treatments are implemented through speech rather than through scalpel,” the ruling noted, citing prior precedent.
Implications for Telehealth
The case raises significant concerns about the future of telehealth, particularly regarding cross-state medical practice. With telehealth services expanding, many advocates argue that restrictive licensing laws hinder patient access to specialized care. The decision underscores the ongoing legal and policy debate over how to balance state-based medical regulations with the increasing demand for nationwide telehealth services.
Next Steps
While the case has been dismissed, the plaintiffs have been granted the opportunity to amend their complaint. If they choose to proceed, they may attempt to refine their legal arguments or introduce additional evidence to support their claims.
The Pacific Legal Foundation, along with Senior Attorney Caleb R. Trotter, has announced that they will be filing an appeal to challenge this court decision. Their appeal will seek to overturn the dismissal and continue the legal battle over California’s telehealth licensing requirements.
This lawsuit represents a critical moment in the evolving landscape of telehealth regulation. As virtual care becomes more prevalent, challenges to state-based medical licensing frameworks are likely to continue, shaping the future of healthcare accessibility in California and beyond.