The end of a federal program that provides internet subsidies to low-income families could leave hundreds of thousands of North Carolinians without access to online health services.
Nearly 900,000 households across the state participate in the Affordable Connectivity Program, a $14.2 billion federal program created through a sweeping infrastructure package approved by Congress in 2021. People who met the ACP’s eligibility requirements saved $30 to $75 a month on high-speed internet, a discount that effectively amounted to free internet access for many.
But funding for the program is about to dry up. The Federal Communications Commission stopped accepting new applications for subsidies in February, and existing enrollees are expected to lose their benefits in April.
The program could continue if Congress approves additional funding. The Biden administration asked Congress for a supplemental request of $6 billion in October, but nothing has come of it.
And the likelihood of an extension happening before the deadline is becoming increasingly bleak.
“We have real concerns that nothing will get done before the money runs out,” said John Graham, president of the N.C. Telehealth Network Association. “I’ve talked with people sort of anecdotally about this, and there's real concern that a lot of people are going to have to disconnect.”
Cost of connectivity
Graham was part of a panel that led a discussion on digital equity during a summit convened in Raleigh last week by the N.C. Rural Center. Affordability, he noted, is one of the biggest barriers to broadband adoption in rural communities.
The ACP eliminated that barrier for many rural households, giving residents in underserved areas access to telehealth services, a service that became a lifeline during the pandemic when many physician offices were only seeing patients remotely and many people hesitated to venture out in public. These services have research-proven benefits, with a 2021 study finding that they “decrease staffing costs, travel costs, and travel time, and increase the ability of residents to seek care (including specialty care) that they otherwise would not be able to access in remote locations.”
Graham said telehealth “exploded during the pandemic,” accounting for about 80 percent of the state’s patient visits in 2020. The share has since decreased to about 15 percent.
“That’s still a significant number,” he said. “It suggests that telehealth really is a viable option in terms of improving access to health care overall.”
The sudden loss of the internet subsidies could “create real issues of trust” among rural populations, according to Graham. If the program is restarted, they may not be willing to re-enroll.
Health access improves with broadband
Graham’s concerns were echoed by Emily Gangi, policy director for the N.C. Division of Broadband and Digital Equity. She said the success of a $2.5 billion plan to improve the state’s broadband infrastructure depends on people being able to pay for high-speed internet.
“Several Republican and Democratic federal representatives and state legislators find value in the Affordable Connectivity Program,” she said. “They recognize that it's not going to do any good to spend $2 billion to build that infrastructure if so many households in our state can't afford to subscribe to it.”
And better access broadband has already proven its worth in improving the health of rural communities.
A feasibility study conducted by Gangi’s office determined that, for instance, in the 20 western North Carolina counties that are part of the Appalachian region, “a disproportionate number of individuals in the 20 counties live without access to basic health care services and access to specialists like cardiologists, because of distance and limited provider availability.”
The study “confirmed where broadband and telehealth services exist, health care access is improved, patients are more aware of their conditions and equipped with self management techniques to alert their health care professional when concerns arise.”
Gangi is hopeful that Congress will move to extend the ACP, but she said “it’s going to take all of us to make it happen.”
“We're still trying to advocate to our congressional delegation from North Carolina,” she said. “Congress could still act. They could still put more money toward it. So if you feel like they should, I encourage you to contact them.”
This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.
North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.
