Blog & News
Monitoring Broadband Expansion and Disparities using Data from State Health Compare
April 13, 2023:Introduction
The onset of the COVID-19 pandemic underscored the importance of telehealth services to people across the U.S. and the crucial role of broadband internet access in providing those services. Telehealth continues to be a popular and often necessary way for patients to access care, and federal and state governments are now making significant investments to expand and ensure affordable access to broadband internet.1
For these reasons, it is important to monitor changes in the share of the population with broadband internet as an indicator of access to care. SHADAC analysis of 2021 American Community Survey (ACS) data indicates households’ access to broadband internet has increased by 3.8 percentage points (PP) since 2019, rising to 90.1% (from 86.3%).
State Broadband Efforts
The percentage of households with broadband access varies across the states, ranging from a low of 81.8% in Mississippi to a high of 93.4% in Washington. Though every state experienced some increase in household broadband access, a few states showed larger expansions in access.
Out of all states, Arkansas saw the largest increase at 5.4PP, rising to 85.7% from 80.3%. Former Arkansas Governor Asa Hutchinson and the Arkansas General Assembly had made broadband a “top priority,” working to expand the state Broadband Office by increasing staffing and enhancing services.2, 3 The state also developed the Arkansas Rural Connect (ARC) grant program to expand broadband access in rural communities, and they recently announced a first-in-the-nation partnership with national non-profit EducationSuperHighway to develop best practices and programs to address broadband affordability.4
Rates of broadband access increased by similar amounts in South Carolina, rising to 87.8% from 82.4%. South Carolina has engaged in significant broadband expansion initiatives over the past few years, approving nearly $30 million in broadband expansion projects in early 2021 and spending nearly $50 million in CARES Act funding on broadband-related projects in 2020.5
Despite gains in access, disparities by income level remain
Despite overall growth in broadband internet access, there are still sizable disparities in access between households of different income levels.
For example, though 91.1% of Minnesota households have broadband access (higher than the national average), only 73.1% of low-income households in Minnesota (under $25,000 per year) have broadband internet (below the national average of 74.7%).
In general, households with an income under $25,000 per year have the lowest percentage of broadband access, and households with an income over $50,000 per year have the highest percentage, though that difference varies by state. South Dakota shows the largest gap at 26.2PP: only 67.8% of low-income households have broadband access, compared to 94% of high-income households. Mississippi has a sizable disparity between income levels as well, with a 25.4PP difference between high- and low-income households.
Delaware and Oregon see the smallest disparities between income levels, showing a gap of only 15.8PP and 15.9PP between high- and low-income households, respectively. Those two states have some of the highest percentages of broadband access for low-income households as well, with 79.7% of low-income households in Delaware reporting broadband access and 79.5% in Oregon.
Considering these disparities, some states are taking steps to address broadband affordability;
The 2022 Virginia Telecommunication Initiative guidelines include grant scoring criteria that encourage applicants to be aligned with the state’s efforts to bring low-income households affordable access to broadband internet.6
The Minnesota Office of Broadband Development recently began the process of establishing a statewide digital equity plan which would focus on addressing internet service affordability and reducing gaps in device access, and digital skills.7
In 2021, California passed a historic law directing $6 billion toward improving broadband access and affordability, with multiple provisions intended to improve internet speed, increase access, and lower internet costs for consumers.8, 9
Conclusion
On both national and state levels, access to broadband internet improved from 2019 to 2021. States have begun several promising broadband expansion initiatives and are using available federal and state grant funding to bolster broadband infrastructure and affordability. However, as states continue working toward greater broadband access and navigating an influx of funding for expansion projects, it is necessary to ensure those improvements are specifically targeted to address existing disparities in access.
The U.S. Census Bureau recently launched a data dashboard exploring the impact of federal broadband initiatives on local economies, including different access measures and displays for data on local employment statistics, wages and income, home values, and more. This is a helpful tool for visualizing the local effects of broadband infrastructure investment; explore it here. |
About the Data
The data cited here can be accessed through SHADAC’s online data tool, State Health Compare, using the measure “Percent of households with a broadband internet subscription” for the years 2019-2021. The estimates come from SHADAC’s analysis of the American Community Survey (ACS) Public Use Microdata Sample (PUMS). All differences described are statistically significant at the 95% confidence level unless otherwise specified.
1 Broadband Expansion Initiatives—The Council of State Governments. (2022, May 11). The Council of State Governments. https://www.csg.org/2022/05/11/broadband-expansion-initiatives/
2 AR Rural Connect. (n.d.). Arkansas Department of Commerce – Broadband Office. https://broadband.arkansas.gov/ar-rural-connect/
3 Connecting Arkansas: A Path to Economic Prosperity. (2021). Arkansas Department of Commerce. https://www.arkleg.state.ar.us/Calendars/Attachment?committee=410&agenda=4735&file=Exhibit+C+-Arkansas+Broadband+Plan.pdf
4 Governor Hutchinson Announces First State Partnership with EducationSuperHighway to Close Broadband Affordability Gap. (2022, November 30). https://www.arkansasedc.com/news-events/newsroom/detail/2022/11/30/governor-hutchinson-announces-first-state-partnership-with-educationsuperhighway-to-close-broadband-affordability-gap
5 Broadband and the Coronavirus Aid, Relief, and Economic Security or “CARES Act.” (2021). South Carolina Office of Regulatory Staff. https://ors.sc.gov/sites/ors/files/Documents/Broadband/Broadband%20CARES%20Act%20Update_1.04.2021.pdf
6 2022 Virginia Telecommunication Initiative (VATI) Program Guidelines and Criteria. (2022). Virginia Department of Housing and Community Development (DHCD). https://dhcd.virginia.gov/sites/default/files/Docx/vati/2022-vati-guidelines-and-criteria.pdf
7 Digital Inclusion. (n.d.). Minnesota Department of Employment and Economic Development. Retrieved March 2, 2023, from https://mn.gov/deed/programs-services/broadband/adoption/
8 Broadband Implementation for California. (2021). https://www.cpuc.ca.gov/industries-and-topics/internet-and-phone/broadband-implementation-for-california
9 SB 156 Fact Sheet: Meeting the Digital Divide. (2021). California Telehealth Policy Coalition. https://www.cchpca.org/2022/01/SB156_factsheet_0921_r3_091621-4.pdf
Publication
What the Growing Medicaid Undercount Means for Data Users and Policymakers
SHADAC hosted a one-hour webinar on Wednesday, April 5th to discuss the rising Medicaid undercount. With many states and stakeholders eager to understand the topic further, this webinar provided an overview of issues related to the Medicaid undercount along with relevant policy implications. View a recording of this webinar below!
Download the slidedeck from this webinar here.
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The extent to which, how, and why 2021 coverage data underestimated Medicaid coverage and/or overestimated uninsurance
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The data and methodology used to calculate the undercount
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How policy and advocacy may be impacted by the growing Medicaid undercount
The panel also answered questions from the audience following their presentation. Due to time constraints, the panelists were unable to answer all audience-submitted questions live. Please click here to view those additional Q&A.
Speakers
Lynn Blewett
Director @SHADAC
Dr. Lynn Blewett is the Founding Director of SHADAC, as well as a Professor in the Division of Health Policy and Management at the University of Minnesota, School of Public Health, where she teaches graduate courses on the U.S. health care system and international health systems. Her health policy experience includes legislative work for the U.S. Senate and state policy work as Director of the Health Economics Program for the Minnesota Department of Health.
Benjamin Sommers
Dr. Benjamin Sommers is a health economist, primary care physician, and professor. Dr. Sommers currently serves as a Senior Counselor to the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services, where he was previously the Deputy Assistant Secretary for Health Policy. He is also the Huntley Quelch Professor of Health Care Economics at the Harvard School of Public Health. His research interests include health insurance markets, Medicaid, health disparities, and the health care safety net.
Robert Hest
Robert Hest is a Senior Research Fellow at SHADAC. Mr. Hest provides expertise in survey data, quantitative data analysis, data visualization, and health coverage policy. Mr. Hest also manages SHADAC’s State Health Compare website, coordinating data processing, quality assurance, dissemination, and documentation of data. In addition, Mr. Hest provides technical assistance to states and other organizations on topics related to health coverage, cost, and access.
Genevieve Kenney
Co-Director and Senior Fellow @Urban Institute
Genevieve M. Kenney is co-Director and a Senior Fellow in the Health Policy Center at the Urban Institute. Dr. Kenney is an expert on Medicaid, CHIP, and health outcomes for low-income adults, children, and families. She has also played a lead role in a number of Medicaid and CHIP evaluations, including multiple congressionally mandated evaluations of CHIP, and has conducted state-level evaluations of the implementation of managed care and other service delivery reform initiatives and policy changes in Medicaid and CHIP.
Joan Alker
Executive Director @Georgetown University Center for Children and Families
Joan Alker is the Executive Director and Co-Founder of the Georgetown University Center for Children and Families and a Research Professor at the McCourt School of Public Policy at Georgetown University. She is a nationally recognized expert on Medicaid and the Children’s Health Insurance Program (CHIP) and is the lead author of CCF’s annual report on children’s health coverage trends.