Courtesy fernandez.house.gov
The Telehealth Access for Tribal Communities Act of 2024 would extend a provision from the COVID-19 Public Health Emergency that allowed for audio-only telehealth for Medicare beneficiaries in tribal communities, which will otherwise expire at the end of the year. US Rep. Teresa Leger Fernández, D-NM, represents the state’s 3rd Congressional District and numerous tribal areas, and is a co-sponsor of the bill—which was introduced last week—along with fellow Democratic members in the US House Raúl M. Grijalva, Gwen Moore and Raul Ruiz of Arizona, Wisconsin and California, respectively. The bill has support from the National Indian Health Board, the Jemez Health and Human Services Department in New Mexico and Navajo Nation President Buu Nygre, among others. The following interview has been edited for clarity and concision. (Julia Goldberg)
The COVID-19 pandemic highlighted certain inequities, several of which this bill seem to point toward. Can you speak to those?
We know that in tribal communities we don’t have good access to medical care. We do not have enough practitioners, and we also don’t have internet connection. We have more seniors in tribal communities, so the ability to provide telehealth to tribal members and those living in rural areas—as well as urban Indians, because this applies to urban Indian communities as well—was groundbreaking. We found through the public health emergency that we had almost 50% Medicare resource visits were using telehealth, but telehealth audio-only; that is key, because of the fact that there isn’t easy access to broadband or the internet, or…it might be you don’t have the computer, right? You do not have the hardware, the software to be able to access telehealth that is visual as well as audio. So this is the good thing that happens when you have hearings. We had a hearing and one of our witnesses said, ‘By the way, the ability to have audio only telehealth is expiring.’ And I said, ‘Oh, we need to fix that. And we need to fix it permanently.’
Do you think people will receive equitable health care with audio-only telehealth or is it a solution for a problem that needs a better solution down the line?
This is a piece to improve health care in rural areas; it is not a final solution. We know that we don’t have enough rural health providers. And we also know that it’s very hard for tribal communities [that] live far away from the health clinics to get there. And so this is an important piece for that aspect of access. But you still need to go in and see a doctor. We still want doctors to be physically examining patients, to be establishing the rapport; but there are many times when you can get the care you need without sacrificing quality through telehealth and audio. It does not fix the whole problem, but it does address the improvements we can make and we should make.
Gov. Michelle Lujan Grisham recently advertised in Texas to recruit their medical professionals here. Could that potentially help with shortages in rural areas?
I think it’s a brilliant idea, right? If I were a medical provider practicing in a state that restricts my ability to fully care for my patients the way Texas does, I would want to move to a state that values healthcare as healthcare; that does not politicize healthcare. New Mexico did not politicize the pandemic. We tried very hard to respond with the information we had at the time to protect our people, to provide the vaccine, to do what is needed to keep people alive. We do not politicize access to reproductive healthcare. We do not politicize access to healthcare for trans individuals. So if I were a doctor or healthcare provider, I would want to go to a state that values healthcare as healthcare.
