Rural patients in areas without broadband cannot access telemedicine, widening the care gap for 28% of rural Americans

28% of people in rural areas and 24% in Tribal lands lack access to high-speed broadband internet, making video-based telemedicine — which became a critical care delivery channel during and after COVID-19 — functionally unavailable to the populations that need it most. So what? Rural Americans already travel an average of 40+ miles to reach a specialist, and telemedicine was supposed to eliminate that barrier, but without reliable internet, they are excluded from the solution while urban patients benefit, widening the urban-rural health disparity. So what? Dropped calls and video feed interruptions during telehealth visits lead to incomplete assessments, miscommunication, and patient dissatisfaction — a dermatologist cannot evaluate a skin lesion through a pixelated, frozen video feed, forcing an unnecessary in-person visit that the patient may not make. So what? Rural clinics that invested in telehealth infrastructure based on pandemic-era funding and policy find they cannot sustain utilization because their patient population cannot connect, threatening the financial viability of facilities that serve as the sole healthcare access point for entire counties. So what? The Affordable Connectivity Program that subsidized broadband for low-income rural households ended in 2024, removing the only federal program that directly addressed the cost barrier to telehealth-enabling internet access. So what? Chronic disease management programs that depend on remote monitoring (e.g., continuous glucose monitors for diabetics, blood pressure cuffs for hypertension) cannot function without connectivity, leaving rural patients with worse outcomes for conditions that are already more prevalent in rural populations. This persists structurally because broadband infrastructure buildout in low-density areas is not commercially viable for ISPs, federal broadband subsidies are inconsistent and expire, and healthcare policy treats telemedicine as a solved connectivity problem when the physical infrastructure does not exist.