In rural America, the road to better health runs through broadband

OPINION:

When people picture the challenges facing rural health care, they tend to picture buildings: the hospital an hour away, the clinic that closed, the specialist who is three counties over. Those problems are real and we are always working to address them. But increasingly, the most important piece of medical infrastructure in a rural community is not a building at all. It is a reliable internet connection.

In the hills and towns of southern Indiana, where I represent the Ninth Congressional District, I have watched telehealth go from a novelty to a lifeline. A veteran can meet with a VA psychologist without driving two hours to Indianapolis. A diabetic grandmother can have her readings monitored remotely instead of making a weekly trip she can barely manage. A new mother in a county without an obstetrician can keep her prenatal appointments. None of this works without access to broadband. And in too much of rural America, broadband is still not there.

Closing that gap has been one of the great bipartisan projects of the last decade, and Congress has committed tens of billions of dollars to the effort. But money alone does not lay fiber or build towers. We have seen the funds disappear into providers that overpromised, underdelivered, and walked away. They won federal grants on promises they couldn’t or wouldn’t keep. This left rural residents waiting years for connections that never came.

That is the problem the Rural Broadband Protection Act was written to solve, and last month it became law. I sponsored the House version because I had seen the stakes up close. Before Congress, I spent eight years in the Indiana State Senate representing the 47th District, at the time, one of the most unserved areas of the state for internet access. I helped author and pass legislation that led to the establishment of Next Level Connections, Indiana’s roughly $350 million broadband grant program, and legislation to steer those dollars toward the communities that had nothing at all. Indiana built one of the most effective, technology-neutral application processes in the country, and I watched fiber reach farms, families, and small towns that had waited years.

The new federal law applies these same principles nationally. It requires the Federal Communications Commission to vet applicants for high-cost universal service funding before the money goes out the door. Providers must confirm they have the technical and financial wherewithal to do the job. They’ll also face penalties if they default before delivering.

In plain terms: prove you can build it before we pay you to build it. This will ensure that every dollar that goes to a qualified provider serves places like farmhouses, clinics, or schools.

I want to be clear about why this is a health care issue and not merely a technological one. Rural Americans are older, sicker, and farther from care than their urban counterparts. Telehealth does not replace the rural hospital, and we should keep fighting to keep those hospitals open. But for millions of people, a reliable connection is the difference between getting care and going without, between catching a problem early and ending up in an emergency room. When we protect the integrity of broadband funding, we protect access to medicine.

I’m proud to say the bill drew support from both parties because the policy is not partisan. Whether you represent a small town in Indiana or a rural stretch of Minnesota, you want the federal dollars meant for your constituents to reach your constituents. Stewardship of taxpayer money and concern for rural patients are not competing values; they should be a complement to each other.

Yet, there is more to do. The FCC must now write and finish the rules that bring this law to life. Congress must hold the agency to a serious timeline, so the protections are in place before the next round of funding goes out. And we should continue to push for permitting reforms and flexibilities that let providers build faster and cheaper.

Getting this right is among the most consequential things we can do for the health of rural Americans. Rural communities deserve to be more than an afterthought in the digital economy and the evolving health care system. The same connection that helps a child get a wellness check lets her grandfather see his cardiologist. That connection is not a luxury. It is critical infrastructure, and it is long overdue.

• Rep. Erin Houchin represents Indiana’s Ninth Congressional District.