Save Tele-Health Services for the Homebound

Petition Title: Permanently Extend Medicare and Medicaid Telehealth Coverage for All Homebound Beneficiaries – Save Lives, Improve Outcomes, and Cut Taxpayer Costs Before January 30, 2026 Expiration

Petition Description
The temporary COVID-era flexibilities allowing telehealth services from home under Medicare and Medicaid are set to expire on January 30, 2026. After this date, coverage will largely revert to rural areas and behavioral health services, leaving millions of homebound individuals without this essential lifeline.

This policy reversal will deny equitable access to care for the most vulnerable, leading to delayed treatments, worsening chronic conditions, increased emergency department (ED) visits, hospitalizations, and ultimately higher costs to taxpayers.

We must act now to make home-based telehealth permanent for all homebound beneficiaries, regardless of location, to prevent unnecessary suffering and fiscal waste.

The homebound population in the United States is vast and diverse, encompassing individuals who cannot leave their homes due to severe physical, developmental, or medical limitations. This includes over 2 million older adults who are fully homebound—more than 1.5 times the nursing home population—often due to multiple chronic conditions, frailty, or dementia.

Up to 7 million more older adults are semi-homebound, with annual incidence rates of becoming homebound ranging from 1.8% to 3.1% among Medicare beneficiaries.

The community also includes children and young people with rare diseases and congenital conditions—affecting 1 in 25 children born, with rare diseases impacting an estimated 30 million Americans overall, roughly half of whom are children. Additionally, millions of children have special health care needs (over 14.5 million, or 20% of U.S. kids), including developmental disabilities with a prevalence of 17.76% among those aged 3-17, many of which severely limit mobility and require ongoing care. Children and adults disabled by catastrophic accidents—such as traumatic brain injuries, spinal cord damage, or severe burns—further swell this group, often facing lifelong homebound status due to mobility impairments.

Demographically, homebound individuals are disproportionately older (mean age around 80 for incident cases), female (69%), low-income (43% in lowest quartile), and from minority groups (e.g., 11% Black non-Hispanic), with 39% having five or more chronic conditions and 29% with probable dementia. These Americans cannot access traditional in-person care without extreme barriers, making telehealth not a convenience, but a necessity.

Telehealth has transformed healthcare delivery, particularly for the homebound, by enabling early intervention, chronic disease management, and acute care assessments without the need for costly and risky transportation. Key benefits include:

• Improved Access and Outcomes: Telehealth enhances convenience, reduces the spread of infections, supports better control of conditions like diabetes and hypertension, enables remote monitoring for early detection, offers shorter wait times, flexible scheduling, and high patient satisfaction—often proving as effective as in-person care in improving quality of life.

• Reduction in Hospitalizations and ED Visits: Studies show telehealth is associated with fewer hospitalizations and an 18% annual reduction in ED visits, preventing minor issues from escalating into emergencies. For Medicare beneficiaries, it lowers ED revisits and overall utilization.
The financial case is compelling: Telehealth drives massive cost savings for Medicare, Medicaid, and taxpayers by averting expensive ED visits and hospitalizations. Consider these statistics:

• A single telehealth visit costs just $40–$50, compared to $136–$176 for an in-person acute care visit—a direct savings of up to $136 per encounter.

• Avoiding one ED visit saves $309 to over $1,500, with telehealth cutting ED costs by more than 30% overall.

• Telehealth reduces total medical costs by $1,814 per person, including fewer hospitalizations and outpatient visits.

• For Medicare patients, initial telehealth visits result in $82 lower overall costs per person.

• Net savings per telehealth visit range from $19 to $121 compared to other settings, with broader programs yielding $445,000 to $33 million in Medicare savings.

• CMS estimates telehealth saved Medicare $60 million in patient travel costs alone in 2018, with projections reaching $100 million by 2024 and $170 million by 2029—figures that grow exponentially when including avoided hospitalizations and ED burdens.

• For commercial plans, telehealth saves $126 per visit; similar efficiencies apply to Medicare, where preventing chronic exacerbations avoids thousands in hospitalization costs (average Medicare hospitalization exceeds $14,000).

Without permanent telehealth access, homebound individuals will forego care, leading to health declines that spike ED visits (costing taxpayers $1,644 on average per Medicare ED trip) and hospitalizations—burdening the system with billions in preventable expenses annually.

This is shortsighted policy when telehealth has already proven to lower overall healthcare spending while saving lives.

We demand Congress and CMS act immediately to permanently extend and expand Medicare and Medicaid telehealth coverage to include all homebound beneficiaries—elderly, disabled adults, and children alike—regardless of geographic location or behavioral health status.

Join us in protecting the vulnerable and safeguarding taxpayer dollars. Sign now to ensure no one is left behind!

HOMEBOUND ADVOCACY COALTION