March 7, 2018

The Federal Communications Commission (FCC) published its order on February 22, 2018 to repeal net neutrality, a set of regulations grounded in the premise that internet service providers should treat all web traffic equally as it passes through their networks.  The order’s publication follows a vote by the FCC in December to rescind the net neutrality protections approved in 2015 under President Barack Obama.  According to the order, the net neutrality rules will officially end on April 23, 2018.

What does this mean for healthcare, a sector that relies heavily and increasingly on internet use and reliable connectivity in carrying out its vital work?  Although much remains to be seen, with the repeal set to go into effect in less than two months, healthcare providers should gear up for potential changes that could have significant strategic and financial implications.

“Care is mission critical and there can’t be slow or choppy connections,” explained Jamey Edwards of Cloudbreak Health in Healthcare IT News.  If the repeal goes through, healthcare providers could be forced to pay more to maintain good service.  That would be a challenge for many, particularly the organizations that are already struggling to stay afloat.  Others could decide to pull back on investments in key health information technologies, such as telehealth, which are designed to help improve care quality, safety, efficiency and access.  Smaller organizations, including rural hospitals, which rely on telemedicine to reach patients in remote areas, could be hit hardest.

Not surprisingly, the telecommunications industry supports the repeal of net neutrality, contending that internet regulation impedes competition and innovation.  In a speech delivered the day of the FCC vote, FCC Chairman Ajit Pai, a former attorney for Verizon, described the net neutrality protections put in place in 2015 as “heavy-handed micromanagement” that hampers entrepreneurs and innovators, stifles technological progress and limits consumers.  “We need to empower all Americans with digital opportunity, not deny them the benefits of greater access and competition,” he stated.

Opponents of the repeal, including many technology companies and several consumer advocacy groups, claim that the loss of net neutrality will allow internet service providers (ISPs) to speed up or slow down traffic from specific websites and apps in favor of their own content, giving these powerful companies far too much control over content delivery.  A survey conducted by the University of Maryland indicates that 83 percent of Americans oppose the repeal of net neutrality protections.

In January, the attorneys general of more than 20 states filed a petition to stop the repeal, arguing, as New York Attorney General Eric Schneiderman stated, that it “would turn internet service providers into gatekeepers—allowing them to put profits over consumers while controlling what we see, what we do, and what we say online.”

Mr. Pai and others assert that the repeal will actually boost innovation in telemedicine, artificial intelligence and other areas of healthcare technology development by freeing companies from burdensome, unnecessary regulation, opening the market and stimulating competition—a change that would ultimately benefit patients and the healthcare sector as a whole.

Congress has taken action to block the repeal. On February 27, Democratic lawmakers introduced legislation in both the House and the Senate.  The bill is close to obtaining the support it needs in the Senate, but could face an uphill battle in the House.  However, even if the bill did receive enough House votes to pass, President Donald Trump is unlikely to sign such a bill.  Many lawmakers say they want to make net neutrality an election issue in 2018 if the repeal goes through.  In the meantime, net neutrality is an issue that is likely to be on every healthcare provider’s radar.