Can a Three-Year Campaign Fix Telehealth Licensing?

A new three-year initiative aims to unlock interstate virtual care by targeting US state licensing barriers blocking specialist access

29 May 2026

For a transplant patient in rural Wyoming, finding a specialist is hard enough in person. Finding one online can be harder still, blocked not by geography but by paperwork.

On March 31, 2026, the American Telemedicine Association (ATA) and Johns Hopkins Medicine launched LIFTT, a three-year federal advocacy campaign designed to reduce the licensing fragmentation that prevents physicians from treating patients across state lines. The initiative targets the gap most acutely felt by cancer patients, those with rare diseases, and people managing mental health conditions far from the specialists who know them.

The structural problem is well-documented. Physicians seeking to maintain cross-state patient relationships must obtain a separate licence for each relevant state, a process costing thousands of dollars and hundreds of administrative hours. Rural residents, college students, and transplant recipients carry a disproportionate share of that burden.

Pandemic-era waivers briefly eased the restrictions, and specialist access improved sharply while they held. Their expiry reversed most of those gains.

LIFTT does not propose abolishing state oversight. Rather, it seeks narrow federal carve-outs for specific circumstances: rare expertise, established patient relationships, and rural access. ATA chief executive Kyle Zebley described it as "targeted federal allowances in exceptional circumstances." Helen Hughes, medical director of Johns Hopkins Medicine's Office of Telemedicine, noted that current rules impose unnecessary obstacles on the patients whose specialist relationships are hardest to replace.

Over three years, the campaign plans to engage health systems, brief policymakers, and build a national coalition behind reform. A parallel compact effort on cross-state licensure is also in development.

Whether Congress is receptive is another matter. Licensing sits at the intersection of federal ambition and state sovereignty, two forces rarely eager to share ground. The patients waiting on both sides of those borders may find the politics outlasts their patience.