Friday, July 20, 2018

Telehealth, Lifeline, and Resellers

At its upcoming August meeting, the FCC will vote on issuing a Notice of Inquiry seeking, as Commissioner Brendan Carr put it in a July 11 news release, “to establish a new $100 million ‘Connected Care Pilot Program’ to support telehealth for low-income Americans, especially those living in rural areas and veterans.” While I am not an expert on telehealth, the initiative seems like a worthwhile effort. 
And an important part of what makes it worthwhile, in my view, is the emphasis on supporting low-income Americans. As I have stated frequently in this space, while I am a strong supporter of free market-oriented communications policies, I have always recognized – and long acknowledged – the role “safety net” programs play in aiding low-income persons. That’s why I have long been a supporter of a properly-run Lifeline program. And by properly-run, I mean one that takes seriously the need to police waste, fraud, and abuse.
In the FCC’s current “Bridging the Digital Divide for Low-Income Consumers” proceeding, I filed comments opposing the proposal to limit participation in the Lifeline program only to facilities-based providers. Here is part of what I said:
So, while promoting increased facilities investment is, in general, a worthwhile objective, the primary purpose of the Lifeline program is to promote the affordability of communications services for low-income persons…. The reality is that, today, almost 70% of Lifeline subscribers are served by resellers. As the Commission has recognized, many of these are minorities who rely primarily or exclusively on wireless services, including wireless broadband services, for access to communications. There is no dispute that wireless resellers, like TracFone, have focused their marketing on reaching Lifeline-eligible low-income consumers, and, this, in turn, has increased awareness of the program. In any event, the reality today is that facilities-based providers currently are serving only a minority of Lifeline subscribers, so that discontinuing support for resellers would be very disruptive to the program.
The Commission apparently intends to propose, as it did in the Lifeline “Bridging the Digital Divide for Low-Income Consumers” rulemaking notice, to limit participation in the Telehealth program to facilities-based providers. While I generally applaud initiatives designed to promote facilities-based investment, as I said in my Lifeline comments, “sometimes there are reasons justifying ‘exceptions to the general rule,’”
As the Commission moves forward to consider the issuance of the Telehealth Notice of Inquiry, in light of the Telehealth pilot program’s focus on aiding low-income persons, the agency should consider whether it really makes sense to limit participation to receive support funds only to facilities-based providers.
As with Lifeline, this may be another situation where there is good reason for an “exception to the general rule” favoring facilities investment.