42% of Rural Veterans Enrolled in VA Healthcare Lack Home Internet Access Sufficient for Telehealth, Stranding 1.8 Million Veterans

Of the approximately 4.4 million veterans living in rural areas (nearly one-quarter of all U.S. veterans), about 2.8 million are enrolled in VA healthcare. According to the VA Office of Rural Health, 42% of these enrolled rural veterans -- approximately 1.18 million people -- do not have home internet access capable of supporting VA telehealth services. The VA's attempt to bridge this gap through the ATLAS (Accessing Telehealth at Local Area Stations) pilot program has largely failed: 14 of 24 active ATLAS sites had zero veteran visits in fiscal years 2022 and 2023. Meanwhile, rural VA facilities face the most severe staffing shortages, with facilities like the Togus VA Medical Center in Maine reporting veterans waiting two months for primary care -- triple the VA's own 20-day target. Why it matters: Over a million rural veterans cannot use telehealth to compensate for their distance from VA facilities, so they must travel hours each way for routine appointments or forgo care, so chronic conditions like diabetes, hypertension, and PTSD go unmonitored between infrequent in-person visits, so preventable complications escalate to emergency hospitalizations that are even harder to access in rural areas, so rural veterans experience worse health outcomes and higher mortality rates than their urban counterparts despite identical eligibility for VA services. The structural root cause is that the VA designed its telehealth expansion around the assumption of residential broadband availability, which does not reflect the reality of rural American infrastructure, and its alternative access point program (ATLAS) was deployed without demand validation or integration into veterans' actual care pathways, resulting in expensive installations that sit unused.