Rural Health Care

The rural broadband industry has such a great success story to tell. In the face of transformative technologies, regulatory challenges and increasing competition, you have embraced that change, stayed committed and looked to close the digital divide by delivering the robust and high-quality services that you do every single day. Your commitment to sustainable networks and affordable services is what really has made rural communities fertile ground for innovation. We’ve seen that in so many ways, and this innovation contributes billions of dollars to the U.S. economy every single year.

The Federal Communications Commission's Wireline Competition Bureau (Bureau) announced the E-Rate and Rural Health Care (RHC) programs’ annual caps for funding year 2024. The adjusted amounts represent a 3.6% inflation-adjusted increase to both programs’ funding year 2023 annual caps. The E-Rate program funding cap for funding year 2024 is $4,940,076,139. The RHC program funding cap for funding year 2024 is $706,926,603.

The Federal Communications Commission is poised to raise taxes through its Universal Service Fund—a regressive, hidden tax on consumers' phone bills that funds a series of unaccountable, bloated internet subsidy programs. Rather than giving the FCC carte blanche to expand its balance sheet, Congress must reform the USF's structural problems, reevaluate its component programs, and get the FCC's spending under control. Here is my plan to do that. 

On Dec 12, 2023, Sen Ben Ray Luján (D-NM) wrote to Federal Communications Commission Chairwoman Jessica Rosenworcel requesting input on proposals to modify the contribution base for the Universal Service Fund (USF).

"The USF is a critical tool to provide, among other things, Lifeline internet and voice service to low-income Americans, and reduced-rate internet access to schools, libraries and healthcare providers. Today's opinion underscores the importance—and the validity—of the Congressionally-mandated USF program.

Today’s decision is a victory for the many rural and urban consumers and anchor institutions across the country who rely on the services supported by the federal Universal Service Fund. The USF has been, and continues to be, a critical tool to narrow the digital divide and help address connectivity gaps. The court’s ruling affirms that Congress’ directive to the FCC—over 25 years ago—to collect contributions in support of this vital Fund is constitutional. Other courts considering similar challenges should reach the same conclusion.

The Federal Communications Commission adopted rules making multiple improvements to the Rural Health Care (RHC) Program, which helps rural health care providers afford the broadband connectivity needed for telehealth and telemedicine services. This action will improve program administration and increase participation by allowing health care providers that expect to become eligible in the near future to request funding sooner, aligning program deadlines, simplifying rules for calculating urban rates, streamlining administrative processes, and freeing up unused funding for other purposes.

Here’s what to expect at the Federal Communications Commission's December open meeting.

• We’re going after junk fees that harm consumers and hamper competition.
• We’re cracking down on illegal robotexts.
• We’re making smartphones more accessible to consumers with hearing loss.
• We’re removing barriers to broadband deployment.
• We’re improving health care in rural communities.
• We’re protecting consumer data.
• We’re protecting local TV programming.
• We will also consider an item from our Enforcement Bureau.

Healthcare providers (HCPs) and patients are increasingly relying on telehealth services (healthcare provision over the internet) to provide and seek care. It turns internet access disparities into a health equity concern, i.e., poor internet access can contribute to poor health. In response, two Federal Communications Commission programs in the United States—Healthcare Connect Fund and the Telecom Program—subsidize internet access for HCPs in rural or remote areas.

There have been several lawsuits over the last few years that challenge the legitimacy of the Federal Communications Commission's Universal Service Fund (USF). A suit from a non-profit group called Consumers’ Research argues that USF fees are taxes and that the original creation of the USF was unconstitutional since the Telecommunications Act of 1996 gave the FCC the power to levy taxes.