Under changes the FCC recently proposed, fewer people may receive subsidized broadband service under the Lifeline program. Those left out will struggle to do online tasks such as filling out a job application, or paying bills online. About 12.5 million low-income people across the country, and thousands in Ohio, could be affected.
There are even health implications, since so much of today's medicine relies on patients having the ability to make appointments, refill prescriptions and view test results online.
"There are a lot of unknowns so far," said Liz Lazar, director of programs and partnerships for DigitalC, a nonprofit organization that provides digital literacy and internet access to the under-served.
The FCC commissioners who voted for the changes said reform was needed to reduce waste, fraud and abuse in the program, according to the Association of Health Care Journalists.
The deadline for comments to the FCC is Jan. 24, and the proposal could pass in March or April.
The FCC's Lifeline program gives eligible households a monthly subsidy of about $9, which is passed onto companies that provide internet service, said Bill Callahan, president and director of Connect Your Community, a nonprofit that works on affordable digital access.
About 600,000 Ohioans used the program in 2015, more than Lifeline users found in Michigan (580,000), Pennsylvania (530,000) and Indiana (234,000). Florida and New York had the most Lifeline clients, with roughly 1 million in each state in 2015. The numbers come from the Universal Service Administrative Co., which strives for every American to have low-cost, high-speed internet service.
Without Lifeline, where will these residents turn to get low-cost internet?
"Good question. I have no idea," Callahan said.
FCC Chairman Ajit Pai's proposed changes will make broadband providers get approvals in each state where they want to operate - an expensive and time-consuming task that will probably stop companies from attempting to enter the program, according to Obamaphone.com. Currently, approvals are handled by the federal government.
Pai also wants to place a budget cap on Lifeline spending, according to an Ars Technica story. Once spending hits the cap, no one else will get subsidies even if they qualify. Currently, Lifeline can exceed its current budget, but the FCC has to issue a report justifying the increased spending, Ars Technica said.
The cap - no specific number was included in the proposal - is meant to keep Lifeline spending from rising and to deal with criticism that the program is riddled with waste and fraud, Ars Technica said. The program had a budget of $2.25 billion in 2016, indexed to inflation.
Internet access no longer a luxury
DigitalC's Lazar sees how the lack of internet access affects inner-city residents who sign up for digital literacy classes that the nonprofit offers.A high school student told Lazar how she had to fill out a college financial aid form on her mom's cellphone, because she didn't have a computer with internet access at home.
"The form is a nightmare anyway; I can't imagine doing it on a little, tiny screen," Lazar said.
Libraries offer free wi-fi, but there are limited hours, long lines and no privacy. "That doesn't take the place of having your own connection," Lazar said.
The uncertainty surrounding Lifeline threw a monkey wrench in DigitalC's plans to expand connectivity in Cleveland. For nearly a year, residents in Cuyahoga Metropolitan Housing Authority's Cedar Extension High Rise on East 30th Street, and Lutheran Metropolitan Ministry's Men's Shelter on Lakeside Avenue, both in Cleveland, had access to free broadband service through DigitalC's Connect the Unconnected program. About 550 people were able to use the nonprofit's service, Lazar said.
DigitalC hoped to use Lifeline subsidies to expand Connect the Unconnected throughout the city, Lazar said. Now, that scheme seems unlikely.
Lifeline began in 1985 to help low-income Americans afford their landline phone service, and was updated during the Bush administration to include mobile phones. It got the nickname Obamaphone because the program became more popular, and was expanded to include broadband access, during President Obama's administration.
Low-income families are eligible for a Lifeline service if they are on the Supplemental Nutrition Assistance Program; receive Medicaid, Supplemental Security Income (SSI), the school free lunch program or other national programs that help the needy, according to online facts about Lifeline. A household is also eligible if its annual income is at or below 150 percent of Ohio's Federal Poverty Guidelines.
Internet access and how it affects health
Not having broadband service can contribute to health disparities between rich and poor, said Dr. David Kaelber, chief medical informatics officer for MetroHealth Medical System.Patients with broadband service miss fewer appointments "because we have a way of easily reminding them," with emails and texts, Kaelber said.
He co-authored a 2017 study looking at how internet access influenced who used patient portals such as MetroHealth's My Chart, which lets patients log in and securely view test results, make appointments and chat with a health provider.
The study found that use of patient portals was lower for minorities, low-income people and those who lacked neighborhood internet access.
"Given the scale of investment in patient portals and other internet-dependent health information technologies, efforts are urgently needed to address this growing inequality," the study concluded.
Lazar thinks hospitals, banks and schools should push to provide low-cost internet to those who need it - with or without Lifeline's subsidies - because digital literacy and broadband connectivity are essential to making sure all Clevelanders are ready for the city's economic future.
"We want to set up our residents for success," she said. "We're leaving people behind."
©2018 The Plain Dealer, Cleveland Distributed by Tribune Content Agency, LLC.
