March 10, 2021
One year in, broadband access and telehealth are two big winners under COVID-19
Of all the everyday priorities that changed as a result of the COVID-19 pandemic, few became more crucial than the need to stay connected—to the internet, to teachers and to doctors.
Efforts to expand broadband internet access, and especially systems that could connect individuals to their health care providers, have long benefited from bipartisan support, even if Republicans and Democrats disagree over exactly how to best achieve those expansions. Broadband and telehealth were often discussed but rarely prioritized, the rare instance in which both parties agree on something, only to have it overshadowed by unrelated disagreements.
Not so once the pandemic hit. Suddenly, expanding broadband and telehealth became key priorities for both parties as connectivity became what Jamie Susskind, vice president of policy and regulatory affairs at the Consumer Technology Association, calls "universal primary issues of importance."
"With the shift to working at home and kids learning at home, a brighter light was shone on some of the issues that already existed," Susskind told CQ Roll Call.
Only 11 percent of U.S. consumers used telehealth services in 2019, according to an analysis by the consulting firm McKinsey. Only months into the pandemic, however, the figure rose to 46 percent, with more than three-quarters of Americans expressing interest in using telehealth services going forward. McKinsey estimated that $250 billion in health care costs could be virtualized.
The need for broadband, especially for school-age children, also expanded. The Joint Economic Committee estimated in 2018 that roughly 12 million students lacked the ability to do their homework because they could not connect to the internet at home, with cost being the prohibitive factor. Estimates say that number has likely risen to around 17 million as a result of the pandemic.
Now, with the number of positive cases falling and vaccine distribution on the rise, lawmakers and advocates are beginning to think about how to build on progress made during the pandemic.
"COVID has heightened the importance of both of those issues for everyone," said Susskind. "Now they're trying to think about how to look at this more holistically, to figure out how to get broadband out to everybody, universally. And how to balance the different needs of schools, homes, urban America and rural America."
For John Windhausen Jr., who runs the nonprofit Schools, Health and Libraries Broadband Coalition, the pandemic laid bare a decade of failure by the government to adequately execute the National Broadband Plan, which Congress created as a result of the Great Recession. The idea behind the plan was to alleviate the effects of another national emergency on the so-called "digital divide."
"We've made progress, but we were supposed to have solved the problem by now," Windhausen said. "We need a multifaceted, coordinated national, state and local effort to invest in high-capacity broadband everywhere. And we ought to do that in the next five years, before the next pandemic."
Last December, Congress approved a $3.2 billion fund that would provide $50 a month for internet access to low-income families and individuals who lost their jobs or were furloughed as a result of the pandemic. Also included in the package was $1 billion to deploy broadband on tribal lands and $300 million for broadband in rural areas.
More recently, Congress responded to the pandemic by investing in technology for schools, including more than $7 billion in online learning subsidies that could be made law as soon as this week after the Senate passed a $1.9 trillion COVID-19 relief package over the weekend.
Democrats, in control of the White House and Congress, want to continue investing in broadband as the pandemic tapers. Bicameral legislation introduced last month by Sen. Edward J. Markey, D-Mass., and Rep. Anna G. Eshoo, D-Calif., would direct the Federal Communications Commission to update the National Broadband Plan and analyze the effects of the pandemic on broadband policy.
Democrats want big spending on broadband too. House Majority Whip James E. Clyburn, D-S.C., recently said he will soon reintroduce legislation to provide $100 billion for broadband initiatives, including $80 billion for rural broadband.
Unlike broadband access, the lack of telehealth access prior to the pandemic wasn't an emergency. But over the past year, the expansion of telehealth access has been a rare bright spot. And it's become so popular that lawmakers and policy advocates alike are eager to make it a part of the new normal.
"The pandemic has really been a great lab experiment and has shown that we can expand this benefit," said René Quashie, CTA vice president for digital health policy.
Prior to the pandemic, the main obstacles in the way of telehealth expansion were high cost estimates and questions about whether remote care could properly substitute for in-person health appointments.
Before COVID-19, Medicare's existing telehealth program was available only to individuals living in rural areas, and the Centers for Medicare and Medicaid Services could not pay for telehealth services received while an individual was in their place of residence; they had to travel to a clinic or a hospital in order to participate and have telehealth services covered.
Last March, former President Donald Trump waived those requirements. All of a sudden, Quashie said, "you could be in the densest part of New York City or in the plains of North Dakota and still receive those services."
"What the pandemic has done is amplify the fact that telehealth increases access and that patients seem comfortable using telehealth," Quashie said. "In fact, when you look at a lot of [telehealth] patient satisfaction surveys, they're really generally uniformly very positive."
Now, lawmakers from both parties are clamoring to make those changes permanent by doing away with the geographic restrictions on the program. Bicameral legislation authored by Rep. Mike Thompson, D-Calif., and Sen. Tim Scott, R-S.C., would also give the Health and Human Services Department the ability to waive other telehealth requirements in the event of a future emergency.
Like the broadband bill backed by Markey and Eshoo, the telehealth proposals would commission a study on the use of telehealth during the pandemic.
"Our health care system needs to catch up to the advances in technology," Windhausen said. "And rather than being a barrier, they should be embracing these technologies and realizing that they provide much greater flexibility for both patients and for doctors."
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