S-1261-119
Read twice and referred to the Committee on Finance.
Sponsored by Brian Schatz (D-HI)
What it does
The CONNECT for Health Act of 2025 would make permanent many telehealth flexibilities that were temporarily authorized during the COVID-19 public health emergency, including expanded Medicare coverage for telehealth services. It would remove or reduce geographic restrictions that previously limited which patients could access telehealth under Medicare, and would allow more types of providers and services to qualify for telehealth reimbursement.
Who benefits
Medicare beneficiaries — particularly elderly and disabled patients — who live in rural or underserved areas and face barriers to in-person care. Patients with chronic conditions requiring frequent monitoring. Telehealth technology companies and platforms. Physicians, therapists, and other providers who deliver care remotely. Patients with limited mobility, transportation challenges, or demanding work schedules. Mental and behavioral health patients who may prefer remote visits. Caregivers who would spend less time transporting patients to appointments.
Who is hurt
Brick-and-mortar healthcare facilities — particularly rural hospitals and clinics — that may see reduced in-person patient volume and associated revenue. In-person primary care providers who compete with telehealth alternatives. Patients who lack reliable broadband internet or devices needed for video visits, potentially widening the digital divide in healthcare access. Medicare and federal taxpayers who would bear the cost of expanded reimbursements. Private insurers who may face pressure to match expanded coverage.
Supporters argue
Supporters argue that telehealth dramatically expanded access to care during the COVID-19 pandemic, with Medicare telehealth visits increasing from approximately 840,000 in 2019 to over 52 million in 2020, demonstrating proven demand and utility. They contend that allowing these flexibilities to expire would abruptly cut off care for millions of patients — especially rural and elderly Americans — who have come to rely on remote visits for chronic disease management and mental health treatment.
Opponents argue
Opponents argue that permanently expanding Medicare telehealth reimbursement without robust oversight could accelerate fraud, waste, and abuse — the HHS Office of Inspector General has already flagged telehealth as a high-risk area, with some providers billing for services that were never delivered. They contend that making temporary emergency measures permanent bypasses the careful cost-benefit analysis that major, open-ended entitlement expansions require, and that CBO estimates of long-term fiscal costs remain uncertain.
Constitutional context
Congress has broad authority to structure Medicare under the Taxing and Spending Clause (Art. I, §8, cl. 1), and NFIB v. Sebelius (2012) affirmed wide latitude to set conditions on federal healthcare spending. Post-Loper Bright (2024), any HHS regulations implementing expanded telehealth coverage would face independent judicial scrutiny rather than automatic deference, meaning ambiguous statutory language could be challenged more readily in court.
Checks and balances
Congress would expand Medicare telehealth authority; HHS and CMS would implement and enforce reimbursement rules; courts would independently review agency interpretations under Loper Bright; the Medicare Payment Advisory Commission (MedPAC) provides ongoing oversight and reporting to Congress.
Historical precedent
Temporary telehealth expansions were authorized under the CARES Act (2020) and extended multiple times through subsequent legislation; this bill would make those provisions permanent rather than subject to further short-term extensions.