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Lack of Internet Access Could Be Dangerous for Rural Americans Needing Healthcare

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A couple hold hands while to see a doctor at the Remote Area Medical (RAM) mobile dental and medical clinic in Olean, New York. (June 10, 2017)
A couple hold hands while to see a doctor at the Remote Area Medical (RAM) mobile dental and medical clinic in Olean, New York. (June 10, 2017)
Photo: Spencer Platt (Getty Images)

The current covid-19 pandemic is underscoring just how important it is for rural Americans to have high-speed internet access. “Broadband is no longer a luxury it is a necessity for all rural Americans,” says RJ Karney Director of Congressional Relations at the American Farm Bureau told RFD-TV in a piece recorded for broadcast on the channel. He has been working with Congress to get a bill passed through the Senate that will hopefully better allocate funds to expand broadband access to rural America.

Karney says there is no more important time like the present, amid the covid-19 pandemic, to provide rural America with better internet access. “With regards to healthcare, primary care physicians are seeing a massive decline in rural populations and rural communities,” says Karney. Finding a specialist, as well as a psychologist, is even more rare. Better and further-reaching internet will allow those in rural populations to get the care they need, even remotely.

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Bill S.1822, which is also called the Broadband Deployment Accuracy and Technological Availability (DATA) Act, is currently on the President’s desk, waiting for his signature. The bill changes the way the FCC is required to collect broadband data and, in turn, will hopefully help ISPs report broadband usage more accurately. The bill requires the FCC to “collect and disseminate granular broadband service availability data from wired, fixed-wireless, satellite, and mobile broadband providers,” which isn’t too different from who is required to report now, but the bill calls for a more detailed breakdown on information to create better broadband maps.

Currently, facilities-based broadband providers—or a broadband provider that connects to end-user locations—are required to fill out a form twice a year called Form 477 on “where they offer Internet access service at speeds exceeding 200 Kbps in at least one direction,” says the FCC. That includes fixed-wireless providers like AT&T, mobile providers like Sprint, and satellite providers like Dish. But the form doesn’t ask for enough specific data, which can lead to some companies, who are reporting for the first time, to make mistakes while filling it out. Last year, an error made by a small ISP company, BarrierFree, skewed the FCC’s broadband deployment numbers by millions. According to Free Press, who discovered the error, BarrierFree reported the number of potential census blocks it could provide to, not the actual number. The mistake was due to a misinterpretation of some language in the form.

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Once the bill is passed, the FCC must re-do its Form 477 to address the changes in how broadband data is collected ensure that the public can compare the data maps produced before and after this law goes into effect—and to (hopefully) prevent such errors from happening. Any maps produced after the law is enacted must show where “the areas of the United States that remain unserved by providers,” according to the bill.

Also, the FCC must use those new maps to determine how to fund future federal awards to ISPs so they can expand coverage to residential and mobile customers that are outside of their service areas. According to FCC data, about 20 million Americans lack access to fixed broadband with speeds of at least 25 Mbps down and 3 Mbps up.

However, ISPs have turned down funding to expand their service into rural areas in the past. According to a 2015 article from Ars Technica, AT&T didn’t want to expand its 10 Mbps broadband service to rural America back then because, AT&T claimed, rural customers didn’t need anything faster than a 4 Mbps download speed. And the telecoms are still arguing the same thing today. In a filing by Frontier Communications on December 23, 2019, responding to FCC Chairman Ajit Pai’s announcement of a $20.4 billion rural broadband fund (which replaces the Connect America Fund (CAF) created during the Obama administration), representatives of Frontier, Windstream, and USTelecom said:

“An upload target of 20 Mbps likely drives significant additional deployment costs–up to two to three times as high–compared to a 10 Mbps upload target. At the same time, a 20 Mbps upload target provides little to no additional benefits to the end user customer.”

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If we compare its statement to AT&Ts five years ago, it sounds like the same argument: rural customers don’t need faster internet because ISPs don’t like to spend the money necessary to deploy it.

Yet even if it does drive up costs, ISPs would still be getting free money from the federal government, which means less money out of their pockets going toward establishing more broadband infrastructure. In the same filing, Frontier says that a target 10 Mbps upload will help“Rural Digital Opportunity Fund dollars reach further.” But advertised broadband speeds in the US are really just a best-case scenario. Customers may be offered ‘up to’ a certain speed, but usually get less than that. That 10 Mbps download speed could be closer to that 4 Mbps download speed AT&T argued for in 2015.

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The bill itself is a good thing, says Matt Wood, Vice President of Policy and General Counsel at Free Press. But it’s just the first step on a long trail. Accessibility isn’t just about reaching rural communities. It’s also about affordability, which affects rural and urban communities alike. Federal programs like LifeLine, which provides low-cost phone and internet service to low-income individuals and families, have continually seen cuts since its implementation in 1985. Speaking about the program, Wood says:

“It’s never been funded well enough. It’s never helped enough people to afford broadband, because it you’re above that poverty floor, you’re not eligible for the program anymore. And yet, despite all the attacks it’s gotten, right now there’s about 7 million households taking advantage of the benefit—and it’s $9.25 per month.

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Wood goes on to say that if the eligible population for LifeLine today is roughly 40 million households, that number could swell with the economic depression that is likely to hit as a result of this pandemic. There are two main categories of people who are or will be affected: people who need the internet to work, and people who cannot work, but still need the internet. There will also be school kids who can’t do their homework, people who will be told ‘don’t go out to the doctor’s office,’ but can’t take advantage of their doctor’s telecom service.

While ISPs have waived late-fees and agreed not to cancel service over the next 60 days, that’s just a temporary solution. “These people will need the economic support to afford the connection they are essentially being told they have to have to—quite literally—stay connected,” says Wood.