Telehealth: House Committee on Public Health
- Tori MacFarlan
- Jun 4
- 2 min read
State policy should reflect the growing consensus that telehealth is a permanent delivery modality that must be supported, regulated, and reimbursed in a consistent and rational way.
Texas leads the nation in rates of individuals without health insurance. Approximately 16.7 percent of the population, representing 5.1 million people, lacked health insurance in Texas as of 2024. Texas has ranked first or second in uninsurance rates for more than two decades, and the coverage gap persists across every age cohort, with the highest rates concentrated among working-age adults between 19 and 34. The state's provider shortage compounds the coverage problem. Out of 254 Texas counties, 88 percent are designated as Health Professional Shortage Areas (HPSA), seventy-one counties have no hospital at all, and 246 counties, representing 98 percent of the state, lack adequate access to mental health professionals. Nearly two-thirds of Texas counties do not have a single practicing psychiatrist, and thirty counties have no licensed professional counselor. These conditions are unfortunately consistent with Texas' historic rankings on access to care and reflect structural realities that no single policy can resolve. Telehealth directly addresses the geographic and workforce barriers that prevent Texans who have coverage from using it.
The 2020 COVID-19 public health emergency accelerated telehealth adoption. Medicare telehealth visits increased sixty-three-fold from 2019 to 2020, and in April 2020 more than one-third of all physician appointments in the United States were conducted via telehealth. The Centers for Medicare and Medicaid Services (CMS) documented that telehealth utilization remained elevated well above pre-pandemic baselines from 2022 and beyond, and the Texas Health and Human Services Commission's (HHSC) December 2024 report confirmed sustained growth in Texas Medicaid telehealth utilization. The pandemic demonstrated telehealth's clinical viability across a wide range of conditions and established patient and provider expectations that have not reverted.
Texas extended significant telehealth regulatory relief during the pandemic, including temporary exemptions from in-state licensure requirements that allowed out-of-state providers to serve Texas patients. Those emergency authorities expired on June 15, 2023, and Texas largely reverted to its pre-pandemic regulatory framework, which requires out-of-state providers seeking to practice via telehealth in Texas to obtain a full Texas license or a limited out-of-state telemedicine license, pass the Texas Medical Jurisprudence Examination, and satisfy other requirements that can extend the process by months. As other states have moved to create permanent telehealth registries and interstate pathways, Texas has been slower to codify the pandemic-era flexibilities that demonstrated clear access benefits
