Flawed Federal Programs Maroon Rural Americans in Telehealth Limbo

Uncertainty around federal efforts to expand high-speed internet — and with it telehealth access — to all Americans swirled fast this week after President Donald Trump vowed to end what he called the “racist” and “unconstitutional” Digital Equity Act.

The act is part of the $1.2 trillion Infrastructure Investment and Jobs Act of 2021, which passed under former President Joe Biden and included $65 billion for broadband infrastructure. But before Trump’s latest sniping on his Truth Social site, his administration had already thrown another of the infrastructure bill’s broadband programs into question.

Ten days ago, Republican Sen. Shelley Moore Capito of West Virginia sent a letter to Trump’s Commerce secretary, Howard Lutnick, admonishing him to speed up his department’s review of the $42 billion Broadband Equity, Access, and Deployment Program.

That program had been set to disburse money to states this spring to start connecting homes and businesses, and West Virginia would’ve been among the first recipients.

“West Virginians have waited long enough,” Moore Capito wrote. Moore Capito noted her state was six weeks away from completing preparations to put the federal money to work.

More than 200 mostly rural counties across the U.S. are in dire need of health care providers and reliable high-speed internet, according to a KFF Health News analysis. A quarter of West Virginia’s counties lack these services, making doctor visits either in person or through telehealth difficult or impossible.

The analysis also showed that people who live in these counties tend to be sicker and die earlier than most other Americans.

In Lincoln County, West Virginia, where the Mud River bends through hollows and past cattle farms, stroke survivor Ada Carol Adkins has what she calls “wacky” phone and internet service. It goes out frequently for days at a time.

Adkins has one message for her telecommunications carrier and lawmakers: “Please come and hook me right.”

She’s not the only West Virginian speaking out about bad connectivity. After receiving a briefing on the potential benefits of fiber and satellite connections, the West Virginia Broadband Enhancement Council last week adopted a resolution reaffirming its commitment to deploy high-speed fiber-optic lines.

In Grant County, commissioners sent a letter to Republican Gov. Patrick Morrisey expressing “strong support” for the deployment of fiber lines because of the region’s geographic and economic needs. Fiber, they wrote, is more sustainable and affordable than satellite, such as Elon Musk’s Starlink kits.

“If the residents of Grant County wanted Starlink they could purchase it at any time,” the commissioners wrote.