State Report Card on Telehealth Reform: Progress Slowed in 2023 Leaving Patients Without Access
For Immediate Release
February 26, 2025
State Report Card on Telehealth Reform: Progress Slowed in 2023 Leaving Patients Without Access
Connecticut, Louisiana and Tennessee missed the mark; Colorado and Pennsylvania saw improvements
Boston, Mass – A new report reveals that while state legislatures were active in introducing telehealth bills in 2024, meaningful policy reforms remained elusive. The findings highlight how many states are still failing to ensure broad access to telehealth, with restrictive policies limiting patient choice and provider flexibility.
The report assigns letter grades to all 50 states for the first time, exposing a concerning trend: only nine states earned an A+ or A, while 10 states received an F for their lack of progress. The majority of states fall in the middle, signaling that much work remains to modernize telehealth laws.
Massachusetts received a B for its efforts, mainly due to the number of barriers to innovation and accessing telecare across state lines. States received grades across four key policy areas that impact a patient’s ability to access telehealth care.
“Telehealth is a fundamental tool that can expand access to care, particularly for rural communities, the disabled, and those with mobility challenges,” said Josh Archambault, author of the report for the Pioneer Institute and Cicero Institute. “Unfortunately, outdated telehealth policies in many states continue to limit its full potential, creating unnecessary barriers for both patients and providers.”
Key findings from the report include:
- Modality Neutrality & Patient-Provider Relationships: While most states allow for broad telehealth use, 21 states still need improvements, and four states (AR, KS, TN, NM) require serious reforms to allow patients to establish care relationships over any mode of telehealth.
- Cross-State Telehealth Access: Only eight states (AZ, CO, DE, FL, IN, LA, UT, VT) have set the gold standard for allowing patients to see providers across state lines without restrictions. Most others rely on limited interstate compacts, which do not provide the same level of access.
- Independent Practice for Nurse Practitioners: Despite strong evidence supporting expanded practice rights, opposition efforts blocked all proposed legislation on this issue in 2024, keeping restrictions in place.
The report serves as a renewed call for state lawmakers to act. Telehealth is not a silver bullet, but it is a critical tool that improves healthcare access, enhances efficiency, and lowers costs for patients. States that fail to update their policies risk leaving their residents behind in a rapidly evolving healthcare landscape. The report examines state telehealth policies for fully-insured private insurance plans and laws that impact provider practice in each state. It does not consider Medicaid policies on telehealth.
For more information and to view the full report, visit www.pioneerinstitute.org.
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About the Pioneer Institute:
Pioneer empowers Americans with choices and opportunities to live freely and thrive. Working with state policymakers, we use expert research, educational initiatives, legal action and coalition-building to advance human potential in four critical areas: K-12 Education, Health, Economic Opportunity, and American Civic Values.
About the Cicero Institute:
Cicero Institute is a non-partisan 501(c)3 public policy organization dedicated to advancing constitutional principles and promoting the rule of law. Through rigorous research, advocacy, and legal analysis, Cicero Institute strives to uphold the values enshrined in our nation’s founding documents and ensure that justice prevails for all Americans.
About Josh Archambault:
Josh is a senior fellow on health care at Cicero and Pioneer Institutes. Josh has over fifteen years of experience operating in complex and highly political waters in thirty-five states, and in D.C. at the highest levels. He has become a trusted adviser to Governors, state legislators, senior staff at the White House, and executive branch leadership as they navigate the complexity of health care policy.
Josh holds a master’s in public policy from Harvard University’s Kennedy School of Government and a B.A. in political studies and economics from Gordon College. He and his wife enjoy raising four kids— a mix of biological, adopted, and children experiencing foster care.
Media Contacts:
Stefani Buhajla
Director of Communications
Cicero Institute
media@ciceroinstitute.org
Amie O’Hearn
Director of Communications and Media Relations
Pioneer Institute
aohearn@pioneerinstitute.org
