The article examines the impact of telehealth expansion and high-speed internet (HSI) access on primary care (PC) utilization among Wisconsin Medicaid beneficiaries before and during the COVID-19 pandemic. It finds that while telehealth use increased significantly during the pandemic, disparities in access to telehealth services persisted across sociodemographic groups, including race, sex, age, geography, and income. Despite the expansion of telehealth, individuals with HSI still experienced greater increases in telehealth use compared to those without, but HSI did not fully close existing disparities in PC utilization. Notably, non-Hispanic Black and Hispanic individuals, who had lower pre-pandemic PC utilization, showed greater increases in telehealth use, particularly among those with HSI. However, disparities in telehealth access and utilization by race and ethnicity remained, indicating that telehealth expansion alone may not address health inequities. The study also highlights that individuals with chronic conditions saw a significant increase in telehealth use, which helped offset declines in in-person visits. Overall, the findings suggest that while telehealth and HSI can enhance PC access, they are unlikely to fully close utilization gaps, emphasizing the need for targeted interventions to address systemic disparities in healthcare access.The article examines the impact of telehealth expansion and high-speed internet (HSI) access on primary care (PC) utilization among Wisconsin Medicaid beneficiaries before and during the COVID-19 pandemic. It finds that while telehealth use increased significantly during the pandemic, disparities in access to telehealth services persisted across sociodemographic groups, including race, sex, age, geography, and income. Despite the expansion of telehealth, individuals with HSI still experienced greater increases in telehealth use compared to those without, but HSI did not fully close existing disparities in PC utilization. Notably, non-Hispanic Black and Hispanic individuals, who had lower pre-pandemic PC utilization, showed greater increases in telehealth use, particularly among those with HSI. However, disparities in telehealth access and utilization by race and ethnicity remained, indicating that telehealth expansion alone may not address health inequities. The study also highlights that individuals with chronic conditions saw a significant increase in telehealth use, which helped offset declines in in-person visits. Overall, the findings suggest that while telehealth and HSI can enhance PC access, they are unlikely to fully close utilization gaps, emphasizing the need for targeted interventions to address systemic disparities in healthcare access.