Did Trump's executive orders or regulatory actions alter Medicare coverage for telehealth and home health services?
Executive summary
President Trump’s administration and subsequent actions by Congress and CMS did change Medicare telehealth policy: CMS finalized a Physician Fee Schedule rule expanding permanent telehealth services and making several pandemic-era flexibilities permanent (CMS described this as implementing President Trump’s executive order) [1]. Many other pandemic-era telehealth waivers remained temporary and were extended or allowed to lapse through a mix of funding bills and short-term continuing resolutions—Congress and the White House both played roles in those extensions and expirations, creating repeated “policy cliffs” through 2025 [2] [3].
1. Trump administration used rulemaking to make some telehealth changes permanent
CMS’s Physician Fee Schedule final rule—framed by CMS as carrying out President Trump’s Executive Order on Protecting and Improving Medicare—expanded permanent Medicare telehealth coverage, added dozens of services for telehealth, and removed some barriers such as scope-of-practice limits for non‑physician practitioners so they can deliver care via telehealth [1]. CMS touted that many pandemic-era changes had “unleashed an explosion in telehealth innovation” and that the rule would make many changes permanent for beneficiaries and providers [1].
2. But many telehealth flexibilities remained temporary and vulnerable to funding fights
Separate from CMS rulemaking, several key pandemic waivers were tied to short-term funding language and continued to be extended only by stopgap spending bills or continuing resolutions. Reporting and advocacy groups warned of a “telehealth policy cliff” if Congress failed to act—without congressional intervention, originating‑site and geographic waivers that allowed care in patients’ homes would revert to pre‑pandemic rules after deadlines such as March 31 or September 30, 2025 [3] [2] [4]. Advocacy groups and legal analyses repeatedly urged Congress to legislate permanency [3] [2].
3. The White House and Congress both share credit—and blame—for temporary restorations
Multiple sources show the short-term restorations of telehealth flexibilities flowed from legislation signed by President Trump and actions by Congress. For example, stopgap funding bills signed by the President pushed expiration dates for waivers to later dates (e.g., a funding bill moved a deadline to September 30, 2025) and later continuing appropriations extended flexibilities through January 30, 2026 via H.R. 5371 that the President signed [5] [6]. This record means neither the administration nor Congress alone determined final coverage windows; both shaped the outcome [5] [6].
4. The practical effect for beneficiaries: a mixed landscape of permanence and uncertainty
CMS’s permanent additions via the Physician Fee Schedule broadened what Medicare will cover by telehealth going forward [1]. Yet other commonly used waivers—audio‑only allowances, hospital‑at‑home expansions, originating‑site relaxations—were repeatedly extended only temporarily, exposing providers and patients to sudden changes if Congress did not act [2] [4]. The National Consortium of Telehealth Resource Centers explicitly warned that, absent Congressional action, many beneficiaries would lose the ability to be reimbursed for telehealth visits delivered at home after September 30, 2025 [3].
5. Disputes over responsibility and political framing persist
Fact‑checks and reporting show competing narratives: some Democrats and advocates framed looming expirations as “cuts” tied to the Trump administration, while fact‑checkers noted Congress set many expiration dates and that extensions required legislative action—so liability is contested [7]. Telehealth advocates, including the American Telemedicine Association, publicly congratulated the President and urged permanency while praising prior Trump‑era expansions; at the same time they lobbied both the administration and Congress for clearer, lasting policy [8] [9].
6. What reporting does not say (limits of available sources)
Available sources do not mention specific executive orders that directly revoked or narrowed Medicare home‑health coverage rules separate from the telehealth PFS rule, nor do they document a unilateral White House order that ended telehealth coverage—most changes cited come from CMS rulemaking and Congress’s funding decisions (not found in current reporting). Sources also do not provide a complete list of every telehealth service that was made permanent versus temporary in the 2025 PFS final rule—readers should consult CMS text for granular line‑by‑line coverage [1].
Bottom line: the Trump administration, via CMS rulemaking and executive‑branch advocacy, did move to permanently expand some telehealth services in Medicare, but many pandemic waivers remained conditional and were extended or restored only through stopgap legislation signed by the President—leaving a patchwork of permanent changes plus temporary extensions and recurring uncertainty for patients and providers [1] [6] [3].