July 31, 2019
WASHINGTON, DC – U.S. Senator Angus King (I-Maine), co-chair of the Senate Broadband Caucus, joined a bipartisan group of senators to urge the Federal Communications Commission (FCC) to delay their proposed Rural Health Care (RHC) Program report and order to better address the concerns of rural health care providers and the medical communities. In the letter, the senators highlighted unresolved obstacles that could effectively limit rural Americans’ access to quality healthcare by preventing healthcare providers from participating in the program. The FCC is set to discuss and adopt the proposal in its meeting on Thursday, August 1.
“While we recognize your efforts to adopt much-needed improvements to the RHC program, the proposal neither provides sufficient guidance to applicants nor addresses several of the program’s key issues, and will ultimately lead to increased confusion and funding delays for rural health care applicants and providers,” wrote the senators. “Ultimately, the proposal fails to provide sufficient guardrails of transparency to guarantee confidence that the program will be implemented in a consistent manner.”
“Congress enacted the RHC program to improve health care delivery to rural and underserved communities through innovation in telecommunications,” the senators continued. “Given the importance of this program to the nation’s rural and underserved populations and the public interest in a fair and expedient application and review process, we urge you to postpone a decision on the proposed Report and Order so that rural health care practitioners and broadband providers can work with you to address these concerns and allow the program to succeed to its full potential.”
The RHC Program was created by the FCC after Congress passed the Telecommunications Act in 1996. The Act mandates that the FCC make rural healthcare access a reality by providing public and non-profit rural healthcare providers affordable rates for telecommunications and broadband services.
During his time in the Senate, Senator King has been a strong advocate for healthcare in rural areas that is accessible and affordable. In the June edition of his Inside Maine podcast, Senator King welcomed both U.S. Senator Tina Smith (D-Minn.) and Kris Doody, CEO of Cary Medical Center to discuss rural healthcare policy and ways to improve access to care across the country. Last year, Senator King and Senator Susan Collins (R-Maine) applauded a draft proposal from Federal Communications Commission (FCC) Chairman Ajit Pai that significantly increased funding for the Universal Service Fund’s Rural Health Care (RHC) Program. This increase in the RHC funding cap followed bipartisan letters Senator King led calling for the RHC program to be modernized and strengthened. Also in the 115th Congress, Senator King cosponsored legislation such as the Rural Emergency Acute Care Hospital Act, the Preserve Access to Medicare Rural Home Health Service Act, and the Rural Hospital Access Act, all of which work to better healthcare services in Maine and the United States.
Digital connectivity in rural regions is a key priority of Senator King’s economic agenda to help modernize and grow Maine’s rural economy, support innovation and create jobs. This week, he cosponsored the Broadband Deployment Accuracy and Technological Availability (DATA) Act, which will increase the accuracy of the Federal Communications Commission’s (FCC) broadband availability maps by improving the process by which broadband data is collected. In May, Senators King and Capito reintroduced legislation to measure the economic impact of broadband so state and federal policymakers can understand the return they will receive on any investments in digital infrastructure. The legislation had previously passed the Senate in December, but was not taken up by the House. In April, Senator King joined his colleagues to introduce legislation to promote “digital equity” so Americans of all background can have equal access to the opportunities created by the internet.
In addition to Senator King, the letter was signed by U.S. Senators John Hoeven (R-N.D.), Ron Wyden (D-Ore.), Tammy Baldwin (D-Wis.), Michael Bennet (D-Colo.), Sherrod Brown (D-Ohio), Shelley Moore Capito, (R-W.Va.), John Cornyn (R-Texas), Kevin Cramer (R-N.D.), Martin Heinrich (D-N.M.), Joe Manchin (D-W.Va.), Lisa Murkowski (R-Alaska), and Tom Udall (D-N.M.)
The full letter can be downloaded HERE or read below
The Honorable Ajit Pai
Federal Communications Commission
445 12th Street, SW
Washington, D.C. 20554
Dear Chairman Pai:
We write to urge you to postpone adoption of the proposed Report and Order to reform the Federal Communications Commission’s (FCC) Rural Health Care (RHC) Program that is currently on the agenda for the FCC’s August 1, 2019 meeting. While we recognize your efforts to adopt much-needed improvements to the RHC program, the proposal neither provides sufficient guidance to applicants nor addresses several of the program’s key issues, and will ultimately lead to increased confusion and funding delays for rural health care applicants and providers.
For Americans living in rural areas, physician shortages and hospital closures have made obtaining reliable access to high-quality health care a constant challenge. Broadband connectivity, and the opportunities in telemedicine and telehealth that it supports, allows rural communities to access care. Congress provided the Commission with the mandate to make access to health care a reality through broadband by enacting Section 254 of the Telecommunications Act of 1996. This law states that public and non-profit rural health care providers must receive access to necessary telecommunications and broadband services at affordable rates. It was with this goal that the Commission created the RHC program and the HCF, and it was with recognition of the program’s value that thirty-one senators pushed the FCC to increase the program’s annual spending cap to account for current and future demand last year.
Prior to this increase, the demand for RHC funding exceeded the program’s $400 million annual cap for the first time. We advocated for strengthening the RHC and increasing its funding because we believed then, as we do now, that American families deserve access to high-quality and reliable health care, regardless of the zip code in which they live. The Commission acted in June 2018, increasing the RHC funding cap to reflect inflation. While we are pleased with this action, this amount of funding has proven insufficient to address continued growth in the program.
This lack of sufficient funding, combined with a lack of program rules concerning its allocation, has led to substantial delays for rural health care providers seeking to increase their telemedicine capabilities. Ensuing uncertainty has caused many providers to drop out of the program or to curtail their telemedicine services altogether. We were pleased that the Commission had begun a rulemaking process to address these serious shortcomings. Unfortunately, the Report and Order released on July 11 fails to fix many of the key issues that must be resolved for the program to operate smoothly. The proposal, for instance, does not address the need for more funding, set forth the methodology for calculating the rural and urban rates, nor provide adequate maps to determine the rural area boundaries needed to determine pricing. Instead, it delegates rate-setting to the Universal Service Administrative Company (USAC), an entity that does not have relevant subject matter experience. Ultimately, the proposal fails to provide sufficient guardrails of transparency to guarantee confidence that the program will be implemented in a consistent manner.
Congress enacted the RHC program to improve health care delivery to rural and underserved communities through innovation in telecommunications. Given the importance of this program to the nation’s rural and underserved populations and the public interest in a fair and expedient application and review process, we urge you to postpone a decision on the proposed Report and Order so that rural health care practitioners and broadband providers can work with you to address these concerns and allow the program to succeed to its full potential. We stand ready to assist as appropriate.