Trump vs. Harris: Exploring the Diverging Approaches to Digital Health
Telehealth Support: A Comparative Analysis of the Trump vs. Harris Administrations
Telehealth and digital health has become a crucial component of modern healthcare, especially in light of the COVID-19 pandemic, which necessitated rapid adaptation to virtual care. Both the Trump administration and a potential Harris administration have taken steps to advance telehealth, albeit through differing strategies.
The Trump Administration’s Telehealth Legacy
Under the Trump administration, telehealth saw an unprecedented expansion, particularly during the COVID-19 pandemic. Prior to the public health emergency, telehealth was a relatively underutilized tool, largely limited to rural communities or specialized fields. However, the global pandemic forced a sudden transformation in how healthcare was delivered, and the Trump administration acted swiftly to make telehealth more accessible.
COVID-19 Telehealth Surge
One of the most significant actions the Trump administration took to support telehealth was expanding Medicare coverage for virtual visits. The Centers for Medicare & Medicaid Services (CMS) relaxed regulations, enabling healthcare providers to offer a wide range of services via telehealth that were previously restricted to in-person visits. This was a game-changer, especially for Medicare beneficiaries, who saw their access to care significantly broadened.
In addition to expanding telehealth under Medicare, Trump’s administration also worked with the Federal Communications Commission (FCC) to launch the COVID-19 Telehealth Program, which provided funding to help healthcare providers adopt telehealth technologies. This included efforts to bolster telehealth infrastructure in rural and underserved communities, where access to healthcare has long been a challenge.
Regulatory Rollbacks and Flexibility
The Trump administration's broader approach to healthcare was rooted in deregulation, and telehealth was no exception. To accommodate the rapid transition to virtual care, the administration temporarily relaxed HIPAA (Health Insurance Portability and Accountability Act) requirements for telehealth, allowing providers more flexibility in the technologies they could use to communicate with patients. This move was praised for accelerating the adoption of telehealth, but it also raised concerns about privacy and security risks.
Additionally, the VA MISSION Act, signed by Trump in 2018 and in effect in 2019, expanded telehealth access for veterans, particularly those in rural areas. The Department of Veterans Affairs (VA) became a leader in telehealth implementation, offering virtual care services across state lines, which was critical for veterans in remote locations who otherwise faced significant barriers to in-person care.
Looking Forward: A Potential Trump Telehealth Future
If Trump were to return to office, his administration would likely continue focusing on deregulation and innovation within the telehealth space. While temporary waivers were essential during the pandemic, a future Trump administration may focus on making some of these changes permanent, particularly in areas where the private sector can drive innovation. However, there could be less emphasis on equity-driven policies or targeted investments in underserved communities, which would shape the nature of telehealth’s growth.
Harris Administration’s Vision for Telehealth
As Vice President, Kamala Harris has been part of the Biden-Harris administration, which inherited and extended many of the telehealth flexibilities initiated by the Trump administration. However, a Harris administration is likely to pursue a much broader, more permanent vision for telehealth, with a focus on equity, accessibility, and healthcare transformation.
Continuing Telehealth Expansion
During the Biden-Harris administration, telehealth remained a priority, and significant steps were taken to continue the expanded coverage initiated under Trump. For example, the American Rescue Plan (ARP), passed in 2021, included provisions to support telehealth infrastructure, particularly in rural and underserved communities. This focus on long-term telehealth expansion signals a commitment to making telehealth an integral part of the U.S. healthcare system, beyond emergency situations like the COVID-19 pandemic.
The Harris platform emphasizes the need to make telehealth accessible for more Americans, particularly for those in marginalized communities. This includes policies aimed at expanding telehealth services in mental health care, substance use treatment, and chronic disease management. Telehealth is seen not only as a tool for improving access to care but also as a means of addressing healthcare disparities that disproportionately affect minority populations and low-income communities.
Equity and Health Access
A key differentiator in a potential Harris administration would be the emphasis on health equity. Harris has been a vocal advocate for ensuring that underserved populations—such as people of color, rural residents, and individuals with disabilities—have access to the same quality of healthcare as other Americans. Telehealth plays a pivotal role in achieving this vision by reducing barriers to care that have long persisted in these communities.
Moreover, Harris would likely continue to support policies that ensure Medicare and Medicaid cover telehealth services permanently. By embedding telehealth into the federal reimbursement system, a Harris administration would aim to make virtual care a permanent fixture of the healthcare landscape, ensuring that it is not just a stop-gap solution for public health emergencies.
Behavioral Health and Telehealth Integration
One area where a Harris administration may prioritize telehealth expansion is in behavioral health services. During the pandemic, telehealth proved to be an effective means of delivering mental health and substance use disorder treatment. Harris has expressed her commitment to addressing the opioid epidemic and expanding access to mental health services, and telehealth is expected to play a significant role in both of these areas. Permanent telehealth reimbursement for mental health services, as well as telehealth’s use in preventing opioid overdoses, are likely priorities.
Looking Forward: A Potential Harris Telehealth Future
In contrast to the Trump administration’s deregulation-focused approach, a Harris administration would likely prioritize long-term telehealth infrastructure investment and health equity. Expanding telehealth to underserved populations and making it a cornerstone of chronic disease management, maternal care, and mental health services would be key goals. Additionally, Harris could support more robust data privacy protections to address concerns that arose during the pandemic about the use of technology in healthcare.
Side by Side Comparison of Administrations
Key Differences in Telehealth Support
The Trump administration focused on deregulation to drive private-sector innovation and provide short-term flexibility for telehealth during the pandemic. In contrast, a Harris administration would prioritize systemic changes for permanent telehealth access, emphasizing equity and long-term healthcare reform.
Trump’s policies broadly expanded access, while Harris would target underserved communities, addressing healthcare disparities and making Medicare and Medicaid coverage for virtual visits permanent. Harris’s platform also highlights telehealth for mental health and substance use treatment, with a focus on chronic disease management, aligning with her broader goal of preventive healthcare and equity.
Future Administration Predictions
Politico recently explored potential administration picks for both Trump and Harris, offering insights into how each might shape the future leadership of the Department of Health and Human Services (HHS) and the Department of Veterans Affairs (VA). While these predictions are speculative, they provide a glimpse into the distinct priorities and strategies that could define each administration's approach to healthcare and veterans’ services. It’s worth examining the potential choices and what they could mean for the direction of these critical agencies, as the leaders of HHS and VA will play pivotal roles in advancing or reshaping policies on issues such as telehealth, mental health services, veterans’ benefits, and overall healthcare reform. Whether it’s Trump’s preference for deregulation and private-sector influence or Harris’s likely focus on expanding access and equity, the leadership choices will reflect the overarching goals and values each administration seeks to pursue.
Conclusion
Both the Trump and Harris administrations have made important strides in supporting telehealth, but their approaches differ significantly in terms of focus, scope, and long-term vision. Trump’s focus on deregulation and rapid expansion during the pandemic allowed for an immediate scaling of telehealth services, while a Harris administration would likely emphasize making these expansions permanent, with a clear focus on equity, access, and behavioral health integration.
As telehealth continues to evolve, the future of this critical healthcare delivery method will be shaped by the political direction of the administration in power, with both leaders offering distinct pathways for its advancement.