Ten Things About ACP that Ted Cruz Cares About: #6 ACP and Telemedicine

We're sharing ten questions about the Affordable Connectivity Program (ACP) that  Senate Commerce Committee  Ranking Member Ted Cruz (R-TX) asked New Street Research Policy Advisor and Brookings Nonresident Senior Fellow Blair Levin testified after a hearing entitled The Future of Broadband Affordability.

6. Your written testimony cites several studies regarding telemedicine. Most of these studies are based on information that predates ACP, and none of the studies cite ACP as a benefit. Telemedicine may be a great benefit to Americans, but the studies cited indicate that it would have been a great benefit without ACP.

a. What evidence exists that households, who were not previously purchasing internet and are now doing so through ACP, have used the internet to access telemedicine?

First, the record shows that ACP recipients regard using access to broadband as critical to their healthcare. A recent study found that 75% of ACP participants fear that losing access to ACP will result in losing access to healthcare. This is consistent with another large-scale survey found that 45% of adults believe that inadequate access to technology, including broadband and computers, is a barrier to telehealth, and this was especially prominent among rural residents and adults over the age of 65.¹ That is, ACP recipients and the public generally understand that today broadband access is critical to obtaining healthcare services. 

Second, there are numerous media reports of ACP recipients using and depending on internet access for healthcare.² While I am aware that anecdotes are not the same as data, there should not be any doubt as to the impact of ACP on the use of telehealth. 

Third, there is evidence that when lower income persons have broadband access, they tend to use it for healthcare more than the general population.  For example, the Georgetown study noted above found that “consumers who face greater financial constraints (e.g., those with high deductible healthcare plans or who delay healthcare to save money) are more likely to use eHealth. This finding suggests that eHealth provides a tool for altering and potentially improving consumer healthcare decision-making – especially for those who most acutely bear healthcare costs.”³

Fourth, while I agree with the comment that “Telemedicine may be a great benefit to Americans, but the studies cited indicate that it would have been a great benefit without ACP,” we should not be blind to the fact that the United States government, through Medicare, Medicaid, and the Veterans Administration, is the largest provider of health insurance in the country.  If the general public and private insurers benefit from telehealth, then the government, as a provider of health insurance, would benefit as well, particularly given the overlap of those depending on ACP and those depending on Medicaid and Veterans Administration services.

Fifth, the question implies that ACP recipients might regard the value of telehealth differently than other broadband subscribers.  There is no evidence that this is true.  To the contrary, there is evidence that among those connected, telehealth is quite popular.  For example, a study showed that among patients who recently used telehealth, 73% reported they would continue to use telehealth services in the future, while 41% reported they would have chosen telehealth over an in-person appointment, even if both required a co-pay. Again, there is no reason to believe that ACP recipients would view the benefits of telehealth differently.

Sixth, with respect, I think the question ignores the wisdom, cited before, of skating to where the puck is going.  Not only do we need ACP for telehealth, but we should also be looking for ways in which we can use telehealth for all Americans to improve outcomes and reduce costs.  At the recent House hearing on telehealth cited above, the expert on telehealth correctly noted that “Congress should focus on facilitating improved access to high-quality, integrated telehealth services by strengthening broadband access for disadvantaged and rural populations, establishing digital health literacy programs, conducting research to demonstrate the value of telehealth services (particularly hybrid telehealth modalities), and promoting payment models that increase adoption of well-integrated telehealth services focused on chronic disease management, longitudinal care, and service for disadvantaged populations."

The bottom line is that we should think of ACP as an essential piece of the puzzle for addressing healthcare needs in our country in an effective and efficient manner. And we should not neglect the fact that we also must put together the entire puzzle.

More in this Series

• Ten Things About ACP that Ted Cruz Cares About—And Ten Answers that Could Help Reshape How We Think About the Program
• #2 The Economic Benefit of ACP to the Health Care System
• #3 Net Cost Savings to Government
• #4 ACP and GDP
• #5 ACP vs Private Low-Income Plans 
• #6 ACP and Telemedicine
• #7 ACP and BEAD
• #8 ACP and Education
• #9 Broadband Adoption Research
• #10 What Companies Care About the Affordable Connectivity Program?

Notes

1. Bailey, V. (2021). Limited broadband poses a significant barrier to telehealth access. MHealthIntelligence. https://mhealthintelligence.com/news/limited-broadband-poses-a-significa....
2. See, for example, https://kffhealthnews.org/news/article/internet-subsidy-ending-affordable-connectivity-program-telehealth/ or https://www.cnet.com/home/internet/americans-are-facing-a-mental-health-...
3. Macher, Jeffrey T., John W. Mayo and Olga Ukhaneva "Does the Internet Improve Consumer Healthcare Behaviors, Georgetown University working paper, October 29, 2018.
   

   ---

   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.

© Benton Institute for Broadband & Society 2024. Redistribution of this email publication - both internally and externally - is encouraged if it includes this copyright statement.

For subscribe/unsubscribe info, please email headlinesATbentonDOTorg

Kevin Taglang
Executive Editor, Communications-related Headlines
Benton Institute
for Broadband & Society
1041 Ridge Rd, Unit 214
Wilmette, IL 60091
847-220-4531
headlines AT benton DOT org

Share this edition:

Broadband Delivers Opportunities and Strengthens Communities