A new analysis published in JAMA Health Forum reports that approximately 11.9 million Americans live in areas with broadband speeds below the Federal Communications Commission’s minimum threshold of 100/20 megabits per second (Mbps), preventing reliable telehealth connections. The study found that the vast majority of those affected—about 88%—reside in rural communities. Researchers concluded that inadequate internet infrastructure and the cost of broadband subscriptions are major contributors to ongoing disparities in virtual care access.
The University of Vermont research team combined multiple data sources to assess broadband availability and telehealth access across 41 states, covering a total population of more than 249 million people. The investigators mapped areas they classified as broadband deserts, defined by downstream/upstream speeds below the FCC’s 100/20 Mbps threshold, and compared that geographic overlay with measures of telehealth capability and household technology access.
The analysis found concentrated broadband shortfalls in rural areas, particularly in parts of the South and the West. Because 88% of people living in broadband deserts are rural residents, the report underscores that communities already facing limited local health resources—such as fewer primary care clinicians and longer ambulance response times—may be further disadvantaged by poor connectivity.
Researchers described these differences as “persistent broadband disparities,” with limited internet infrastructure and lower subscription rates compounding challenges in accessing timely medical care for traditionally underserved populations.
The study emphasizes that while broadband availability and subscription are necessary for telehealth, they are not sufficient to ensure use. Researchers reported that about 95% of rural residents have access to a computing device and roughly 89% report a broadband subscription, yet poor connection quality still prevents effective virtual visits. The authors identified several non‑connectivity barriers that hinder telehealth adoption, including:
The paper notes that these socioeconomic, behavioral and health system factors interact with infrastructure limitations to determine whether telehealth can actually improve access.
Investigators highlighted that telehealth has the potential to mitigate gaps in access to primary, specialty and emergency care for patients living in remote or underserved areas, but that potential is constrained when connections are unreliable. Even in households that nominally meet prerequisites—device ownership and a broadband subscription—insufficient speeds and unstable connections can interrupt video visits, limit diagnostic capability, and reduce clinician willingness to use virtual care for certain clinical tasks.
Because many individuals living in broadband deserts are also in areas with limited in‑person services, the connectivity shortfall magnifies existing barriers to timely care.
University of Vermont researchers recommended that policymakers consider targeted actions to expand telehealth access by addressing both infrastructure and reimbursement. Specifically, the study suggests:
The authors emphasized that resolving infrastructure gaps is necessary but must be paired with interventions addressing digital literacy, device access and the availability of telehealth services to realize telehealth’s full access potential.
The study places its findings within the broader trajectory of telehealth use. Virtual care utilization surged during the COVID‑19 pandemic when many in‑person services were restricted. While usage has declined from pandemic peaks, telehealth remains more common than before COVID‑19, according to industry sources cited in the article. Persistent technology gaps and a patchwork of reimbursement rules continue to challenge wider telehealth adoption, reinforcing the study’s conclusion that both infrastructure investment and policy changes will be needed to expand reliable virtual care.
(Article published Sept. 18, 2026 by Eric Wicklund; reported findings and recommendations are those presented in the JAMA Health Forum analysis by University of Vermont researchers.)