Ending the ACP will Limit the Internet’s Economic and Healthcare Benefits for Low-Income Households
Thursday, January 25, 2024
Digital Beat
Ending the ACP will Limit the Internet’s Economic and Healthcare Benefits for Low-Income Households
What does solving the digital divide look like? The simple answer—getting more people online—is tempting, but it’s just a first step. Focusing only on home adoption rates provides a too limited perspective on the benefits of solving the digital divide. Consistency of connectivity is a key issue for low-income households—and this consistency is an important part of what the Federal Communications Commission’s Affordable Connectivity Program (ACP) offers.
For many households, the digital divide is not a one-time bridge to cross. Instead, online connectivity can be episodic. People may be unable to pay for one or more months of service, resulting in overdue bills. They may be reliant on a mobile service with a data cap. They may be unable to afford any monthly service and rely upon publicly available Wi-Fi or public libraries for connectivity. These challenges show up in the data: Nationally, 49% of low-income households are “subscription vulnerable,” meaning they have lost connectivity in the prior year or worry about whether they can afford next month’s bill. Being unconnected is a recurring condition that takes time and effort to manage.
This is where ACP, the federal broadband benefit, comes into play. The ACP has supported a “gain and sustain” pattern of growth in home internet subscription connectivity. As home internet subscriptions grew in low-income communities during 2021 (due in part to ACP’s predecessor program, the Emergency Broadband Benefit), the ACP helped lock in those gains when 2022’s economic headwinds unfolded (e.g., inflation and the termination of the expanded child tax credit).
The ACP’s role in helping to keep people online has an important consequence: it increases the value of integrating digital tools into approaches to solve social and economic challenges. Maternal mortality rates in the United States offer a concrete example. The United States has alarming trend lines in this arena, with an increase of 60% in maternal mortality between 2019 and 2021. At the behest of Congress, the Federal Communications Commission has mapped where maternal mortality is highest—and the maps of places where new mothers die at the highest rates look a lot like maps of where household internet subscription rates are low.
Fortunately, there are promising ways to address maternal mortality that rely on home internet access for new mothers. In Louisiana, Ochsner Health has had success in using digital tools to monitor at-home blood pressure and other risk factors for pregnant women, resulting in fewer hospital admissions and caesarean section procedures. Such remote maternity online monitoring has reduced unexpected neonatal intensive-care unit admissions by 27%.
The healthcare benefits of using digital tools extend beyond maternal mortality. Telehealth is associated with people maintaining their participation in opioid treatment programs and telehealth can reduce the cost of health care service delivery with only marginal increases in in-person visits. Given the amount the United States spends on Medicare and Medicaid, universal, sustainable broadband should be seen as a huge opportunity to chart a necessary path to improving health outcomes while lowering costs.
The benefits enumerated in these examples fall off steeply if target populations occasionally lose service. Remotely monitoring the blood pressure of pregnant women is of limited value if the home internet subscription lapses. The $30 per month ACP subsidy offers stability in connectivity. With the help of ACP, the subscription-vulnerable household has more breathing room in the household budget and, with consistent at-home service, greater incentives to acquire the digital skills that will help them use the internet to improve their lives.
But the benefits from the ACP don’t stop there. They extend to the broader economy. A 2021 study showed that in areas where discount internet plans were available, there was a positive impact on employment rates and earnings of eligible households. With greater labor force participation and decreased probability of unemployment, low-income households saw a $2,200 annual earning boost from subsidized internet programs. Indeed, a recent review of studies on broadband’s economic impact found “that broadband adoption positively affects employment.” For the ACP specifically, recent analysis finds that each dollar of the ACP subsidy generates $3.89 in spending for households. Overall, it is hard to escape the conclusion that home broadband adoption is an engine of economic opportunity for households in most need.
And let’s not forget the ACP’s benefits for social service suppliers. Greater certainty in at-home service for clients makes it more attractive to invest in solutions in health care and job training. The ACP is part of an emerging innovation system where the value of investing in social solutions is greater due, in part, to more consistent connectivity for low-income people. The ACP has brought stability to the last mile of service delivery for these new solutions.
To follow through on these innovations, the coordination challenges for anchor institutions, community organizations, and the private sector have been considerable – yet parties have risen to the moment and made a difference. A key ingredient in the mix has been the ACP, which has given a measure of certainty for millions of low-income households who may struggle to maintain consistent at-home connectivity. Doing away with the ACP will do more than disconnect many households. It will come at the cost of lost opportunities to address our most urgent problems.
John B. Horrigan is a Benton Senior Fellow and a national expert on technology adoption, digital inclusion, and evaluating the outcomes and impacts of programs designed to promote communications technology adoption and use.
Angela Siefer founded the National Digital Inclusion Alliance (NDIA) in 2015 and has been working in the field we now call digital inclusion since 1997. She has helped physically set up computer labs in underserved areas, managed broadband conferences, conducted research, managed digital inclusion programs, assisted with the Department of Commerce’s Broadband Adoption Toolkit, testified before Congress, and more.
Blair Levin is the Policy Advisor to New Street Research and a nonresident senior fellow at Brookings Metro. Prior to joining New Street, Blair served as Chief of Staff to FCC Chairman Reed Hundt (1993-1997), directed the writing of the United States National Broadband Plan (2009-2010), and was a policy analyst for the equity research teams at Legg Mason and Stif Nicolaus. Levin is a graduate of Yale College and Yale Law School.
The Benton Institute for Broadband & Society is a non-profit organization dedicated to ensuring that all people in the U.S. have access to competitive, High-Performance Broadband regardless of where they live or who they are. We believe communication policy - rooted in the values of access, equity, and diversity - has the power to deliver new opportunities and strengthen communities.
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