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Policy Exploration #3: S.3993 - Equal Access to Care Act (EACA)

Policy Exploration #3: S.3993/Equal Access to Care Act

Overview

The Equal Access to Care Act is a bill that was introduced by senator Ted Cruz of Texas in June of last year. Its intent is to authorize any healthcare workers located and licensed in one state to practice qualified telehealth services in other states for the duration of the COVID-19 emergency. The bill is a standalone authorization well within congressional powers, and the text states it stands to reason that it holds pertinent interest for as long a COVID-19 remains a critical issue.


Beneficiaries

The beneficiaries of this bill would primarily be any and all healthcare providers operating with or exclusively within telehealth and their customers secondarily. The bill would suspend an immense bureaucratic barrier to multistate operations for such providers, allowing them to deliver critical support to consumer bases outside of their license-limited jurisdiction. The bill would also further ease transition between states that have licensing reciprocity policy.


Targets

The targets of the legislation are telehealth providers and, to a lesser extent, state governments. The bill is a simple authorization of said providers to deliver care outside of their states of operation, and cooperation with the authorization, temporary or no, is a targeted responsibility of the presiding state governments in which they presently operate and wish to extend into.


Instruments

As stated, the bill is a brief wholesale emergency authorization. It grants temporally-limited powers to healthcare providers as a public good and does so entirely within congressional authority. The bill makes no use of overly-pedantic definitions or legal structures.


Outcomes

Owed to the simplicity of the legislation, the intended outcomes are limited and straightforward. The immediate and likely sole consequence of the authorization's passage would be granting the powers defined within it, and it is unlikely any notable non-inferential unintended outcomes would occur, especially considering the bill's nature as a temporary provision.


Speculation

A basic authorization for non-physical healthcare delivery across state lines has been an ease-of-burden we've been hurting for long before the pandemic hit. The premise of this bill is a great one and one that would invariably help us immensely, especially considering our business is entirely virtual, and would in turn be a major boon to every practice providing any kind of telehealth and a major improvement on our existing and monstrously endemic healthcare access problem here in the US, particularly concerning the additional burden imposed by COVID. However, I see two critical issues regarding this bill. For one, it was introduced last June, immediately read and reviewed (probably owed to Senator Cruz's seniority and the bill's brief nature) and promptly referred to committee on the same day, where it still is now a full nine months later. This is more or less a critique of the political process in this country that can be broadly applied to a lot of "critical" and "need it yesterday" legislation, but it stands to be said that this comes off as particularly egregious due to the simplicity of the bill and lack of similar authorization in its stead since. Second and more importantly, this is a temporary authorization in light of a specific healthcare emergency. It definitely addresses a major issue universal in the US, but even if it escaped committee and was voted on and implemented tomorrow, the legislative prospects nationally and state-by-state suggest the emergency declaration will be withdrawn well before the year is up, making the real impact of such an important address terribly limited. My suggestion? This bill needs to be passed pronto and it needs to be a permanent resolution, not a temporary authorization. The variability of licensing law among the states is extremely arbitrary, published with the *intent* of protecting consumers, but they instead prevent many of them from being able to access adequate care they can get proverbially delivered to their doorstep. For entities like us, this bureaucratic barrier is especially challenging. I'm grateful for states with reciprocity laws and others that have an ease of acquiring new licensure, but frankly, any and all standards in health should be monitored, secured, and enforced by the federal government due to the universality of need - especially services that are universally applicable, i.e. telehealth services. Without going into further depth, I believe it stands to reason that a simple step like this would present a great leap forward for bridging healthcare discrepancies in this country, and it's something we should all be giving the house, senate and president a phone call for.


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