Affordable internet service in rural communities is limited now that government programs have ended, there are some options

Photo: Keren Fedida/Unsplash
NewsUSA - Rural Americans often enjoy unique lifestyle benefits, but many still face significant challenges in accessing reliable internet connectivity. With the conclusion of the Affordable Connectivity Program in June, which had offered government-subsidized discounts to eligible households, those in remote areas are now seeking alternative solutions to stay connected.

Despite federal initiatives like the American Recovery and Reinvestment Act of 2009 and the Broadband Equity, Access, and Deployment (BEAD) Program of 2021, a substantial portion of Americans who lacked high-speed internet access in 2009 remain disconnected today, as revealed by a study from Arizona State University.

For those in rural communities, access to reliable, high-speed internet is not just a convenience but a critical resource that enhances opportunities for virtual learning, remote work, telehealth, and maintaining social connections with loved ones across distances. After all, the internet has become such an integral part of life that it’s hard to imagine completing daily tasks like paying bills, refilling prescriptions, or staying in touch with distant friends and family without it.

Better access to digital resources stands to enrich rural living in many ways:

Economic Impact: Internet access is the gateway to a host of job opportunities, including remote work which requires high-speed internet. Job seekers need to be able to apply to opportunities online and interview virtually. Reliable connectivity also offers opportunities for online networking, professional development, and industry news.

Educational Opportunities: Many students today access information and coursework for their classes online. Those based in rural areas with unreliable internet at home often turn to public Wi-Fi in local libraries, stores, or coffee shops. Remote learning can become much more fulfilling for rural students with reliable access to digital resources.

Accessible Healthcare: Telehealth has become a modern-day practice for a range of healthcare appointments. The elderly, people living with disabilities, and people who face other challenges accessing healthcare in-person especially benefit from telehealth. Americans in rural areas can gain better access to all these resources with a reliable internet connection.

Social Connection: Connecting with friends and family is important to our well-being. Reliable internet connections can help rural Americans build connections outside their communities through social media, email, and other resources. Additionally, information on local events and news in the community can be more easily accessed with a reliable internet connection.

Many wireline internet service providers (ISPs) are investing in connectivity infrastructure in cities due to their high population density. Rural areas often don’t meet these density requirements – building out miles of cable and fiber and installing poles and other equipment to provide internet to only a handful of homes is a costly investment.

On the other hand, satellite internet companies have continued to invest in rural America. Bridging the digital divide, satellites eliminate the need for local infrastructure, unlike wireline internet providers, making satellite more affordable and accessible. Rural Americans are able to connect and be involved in our online world thanks to satellite internet’s ability to reach areas others won’t.

Hughes, the inventor of satellite internet, offers high-speed, reliable Hughesnet service plans that allow rural customers to connect wherever they live. Hughes newest satellite, JUPITER 3, is the world’s largest and most advanced commercial communications satellite that provides connectivity to rural areas.

In this digital age, the internet should be accessible for all Americans. Satellite connectivity makes the internet available to all Americans, providing basic needs such as connecting with a health provider, applying for a job, doing homework, or reading the news. Satellite internet offers reliable connectivity for rural America.

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Cut costs, not your connection: How to get home internet for less

Photo: Andrea Piacquadio/PEXELS
StatePoint - If you’re struggling with access to reliable and affordable wireless home internet, you’re not alone. In fact, more than 20% of Americans living in rural areas and nearly 30% of Americans living in Tribal lands lack internet access, compared to only 1.5% of those living in urban areas. To make matters worse, the average American shells out about $75 each month for internet service, with over a third saying that cost is one of the biggest hurdles in getting their hands on home internet.

As internet usage increases, the United States faces even more of a nationwide digital divide, but federal government agencies are stepping in to help bridge the gap. In December 2021, the FCC launched a $14 billion initiative to provide people across the United States with affordable internet access through the Affordable Connectivity Program (ACP). Eligible participants can receive up to a $30 discount per month on fixed or wireless internet access, or up to $75 per month on Tribal lands.

So far, the program has provided discounted internet service to more than 20 million households across the country. Here’s how it works:

• Find out if you qualify through your household income and participation in government assisted programs by visiting fcc.gov/acp.

• If you qualify, apply for discounted service by visiting getinternet.gov/apply. If you’re unable to apply online, print the application or call (877) 384-2575 to have one mailed to your home address.

• Once approved, select an internet provider. Metro by T-Mobile is one provider helping bring awareness to the program. In fact, a recent study found that half of eligible households are unaware of the program’s existence or didn’t know anything about it. Metro is out to change that, offering 5G home internet for just $20 a month with Autopay for qualifying ACP households. It’s easy to sign up with no contracts, credit checks or hidden fees. New customers can visit their nearest Metro store to purchase the internet gateway and a Metro phone line to add home internet to their account. Visit metrobyt-mobile.com/acp to learn more about how Metro is helping to bridge the digital divide.

If you’re not eligible for ACP, there are other ways to save a few dollars when shopping around for home internet.

• Take Advantage of Free Trials: Some internet providers offer free trials or money-back guarantees to test out their internet in your home for a certain timeframe.

• Bundle Services: Check what other services you can bundle to save, like your phone plan, cable television and more.

• Autopay Discounts: Wireless companies often offer discounts for those accounts that sign up for autopay billing.

• Internet Connection Type: The type of internet you purchase matters. Fiber and traditional broadband connected through a cable in the wall tends to be more expensive than 5G wireless internet services that use a wireless connection.

Staying plugged into our increasingly digital world on your terms and budget is totally achievable! Get savvy with your shopping and cash in on initiatives and perks to keep your wallet happy while staying connected.

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Affordable Connectivity Program makes internet affordable for low-income households

student working on laptop
The Federal Communication Commission's Affordable Connectivity Program helps millions of households get and save on internet service
Family Features - High-speed internet service is no longer a luxury, but a necessity for everyone, everywhere.

From doing homework to using telehealth, working remotely, connecting with family and friends and more, internet is needed for everyday life, but the cost can make it hard for many to afford.

To help ensure all Americans can share in and contribute to today's internet-based society and economy, Congress created the Affordable Connectivity Program (ACP). Launched Dec. 31, 2021, the Federal Communications Commission (FCC) oversees the program to help eligible households gain access to affordable high-speed internet service.

"For many households, the cost of groceries, gas and rent can eat up the monthly budget, putting internet access out of reach," FCC Chairwoman Jessica Rosenworcel said. "The ACP is the nation's largest-ever broadband affordability effort, supporting internet connections in millions of households. That's progress, but we want to do more to get out the word about this powerful program and reach families that may not know about this benefit."

How the Program Works
The ACP provides eligible households a savings of $30 per month toward internet service or $75 per month for eligible households living on qualifying Tribal lands. Taking part in the ACP could make internet service free if the savings covers the entire price of the plan. Eligible participants will not receive additional money back if their bill is less than the discount.

Eligible households can also receive a one-time savings of up to $100 to buy a laptop, desktop computer or tablet from participating providers. The program is limited to one monthly service discount and one device discount per household (a group of people who live together and share money even if they are not related).

As of June 2023, more than 18 million households have enrolled in the program and are connected to high-speed internet services they need.

How to Enroll
Step 1: Visit GetInternet.gov and submit your application or print out a mail-in application. Households with questions about eligibility or how to apply, or need to request a paper application, can call the ACP Support Center at (877) 384-2575.

Step 2: If approved, contact your local internet provider to select a plan and have the discount applied to your monthly bill. Use the Companies Near Me Tool to find participating internet service providers in your area by city and state or zip code. Consumers can select the type and level of internet service that best suits their needs.

The ACP protects consumers by allowing households to choose an internet service plan that meets their family's needs. Consumers also cannot be denied service because of their credit score or prior debt with a provider, and households enrolled in the ACP can switch providers and plans without incurring additional fees or penalties for early termination.

Eligibility Requirements

  • * Their household income is at or below 200% of the Federal Poverty Guidelines, about $60,000 a year for a family of four or $29,000 a year for an individual
  • * Anyone in the household, including children or dependents, participates in certain government assistance programs like SNAP, Medicaid, WIC, Federal Housing Assistance or other programs
  • * Anyone in the household already receives a Lifeline benefit

    • A household may also qualify for the ACP through a participating provider's existing low-income program.

    For a full list of eligibility requirements and more information, visit GetInternet.gov.


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    Telehealth access for low-income households is coming to an end

    by Sarah Jane Tribble

    California Healthline

    For Cindy Westman, $30 buys a week’s worth of gas to drive to medical appointments and run errands.

    It’s also how much she spent on her monthly internet bill before the federal Affordable Connectivity Program stepped in and covered her payments.

    “When you have low income and you are living on disability and your daughter’s disabled, every dollar counts,” said Westman, who lives in rural Illinois.

    Over 23 million people are enrolled in Congress' 2021 discount program providing online/telephone healthcare services. That could all end this month or in May.
    Photo: Tech Journal/Pixabay

    More than 23 million low-income households — urban, suburban, rural, and tribal — are enrolled in the federal discount program Congress created in 2021 to bridge the nation’s digital connectivity gap. The program has provided $30 monthly subsidies for internet bills or $75 discounts in tribal and high-cost areas.

    But the program is expected to run out of money in April or May, according to the Federal Communications Commission. In January, FCC Chairwoman Jessica Rosenworcel asked Congress to allocate $6 billion to keep the program running until the end of 2024. She said the subsidy gives Americans the “internet service they need to fully participate in modern life.”

    The importance of high-speed internet was seared into the American psyche by scenes of children sitting in parking lots and outside fast-food restaurants to attend school online during the covid-19 pandemic. During that same period, health care providers and patients like Westman say, being connected also became a vital part of today’s health care delivery system.

    Westman said her internet connection has become so important to her access to health care she would sell “anything that I own” to stay connected.

    Westman, 43, lives in the small town of Eureka, Illinois, and has been diagnosed with genetic and immune system disorders. Her 12-year-old daughter has cerebral palsy and autism.

    She steered the $30 saved on her internet toward taking care of her daughter, paying for things such as driving 30 minutes west to Peoria, Illinois, for two physical therapy appointments each week. And with an internet connection, Westman can access online medical records, and whenever possible she uses telehealth appointments to avoid the hour-plus drive to specialty care.

    “It’s essential for me to keep the internet going no matter what,” Westman said.

    Expanding telehealth is a common reason health care providers around the U.S. — in states such as Massachusetts and Arkansas — joined efforts to sign their patients up for the federal discount program.

    “This is an issue that has real impacts on health outcomes,” said Alister Martin, an emergency medicine physician at Massachusetts General Hospital. Martin realized at the height of the pandemic that patients with means were using telehealth to access covid care. But those seeking in-person care during his ER shifts tended to be lower-income, and often people of color.

    “They have no other choice,” Martin said. “But they probably don’t need to be in the ER action.” Martin became a White House fellow and later created a nonprofit that he said has helped 1,154 patients at health centers in Boston and Houston enroll in the discount program.

    At the University of Arkansas for Medical Sciences, a federal grant was used to conduct dozens of outreach events and help patients enroll, said Joseph Sanford, an anesthesiologist and the director of the system’s Institute for Digital Health & Innovation.

    Estimates of how many low-income U.S. households qualify for the program vary, but experts agree that only about half of the roughly 50 million eligible households have signed on.

    “We believe that telehealth is the great democratization to access to care,” Sanford said. New enrollment in the discount program halted nationwide last month.

    Leading up to the enrollment halt, Sen. Peter Welch (D-Vt.) led a bipartisan effort to introduce the Affordable Connectivity Program Extension Act in January. The group requested $7 billion — more than the FCC’s ask — to keep the program funded. “Affordability is everything,” Welch said.

    In December, federal regulators surveyed program recipients and found that 22% reported no internet service before, and 72% said they used their ACP-subsidized internet to “schedule or attend healthcare appointments.”

    Estimates of how many low-income U.S. households qualify for the program vary, but experts agree that only about half of the roughly 50 million eligible households have signed on.

    “A big barrier for this program generally was people don’t know about it,” said Brian Whitacre, a professor and the Neustadt chair in the Department of Agricultural Economics at Oklahoma State University.

    Whitacre and others said rural households should be signing up at even higher rates than urban ones because a higher percentage of them are eligible.

    Yet, people found signing up for the program laborious. Enrollment was a two-step process. Applicants were required to get approved by the federal government then work with an internet service provider that would apply the discount. The government application was online — hard to get to if you didn’t yet have internet service — though applicants could try to find a way to download a version, print it, and submit the application by mail.

    When Frances Goli, the broadband project manager for the Shoshone-Bannock Tribes in Idaho, began enrolling tribal and community members at the Fort Hall Reservation last year, she found that many residents did not know about the program — even though it had been approved more than a year earlier.

    Goli and Amber Hastings, an AmeriCorps member with the University of Idaho Extension Digital Economy Program, spent hours helping residents through the arduous process of finding the proper tribal documentation required to receive the larger $75 discount for those living on tribal lands.

    “That was one of the biggest hurdles,” Goli said. “They’re getting denied and saying, come back with a better document. And that is just frustrating for our community members.”

    Of the more than 200 households Goli and Hastings aided, about 40% had not had internet before.

    In the tribal lands of Oklahoma, said Sachin Gupta, director of government business and economic development at internet service provider Centranet, years ago the funding may not have mattered.

    “But then covid hit,” Gupta said. “The stories I have heard.”

    Elders, he said, reportedly “died of entirely preventable causes” such as high blood pressure and diabetes because they feared covid in the clinics.

    “It’s really important to establish connectivity,” Gupta said. The end of the discounts will “take a toll.”


    This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF. Subscribe to KFF Health News' free Morning Briefing.
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    Federal Affordable Connectivity Program offers low-cost internet to eligible citizens

    Photo:NAPSI
    NAPSI -- A fast, reliable Internet connection has become a critical part of our daily lives. From remote learning and working to networking and searching for jobs, Americans everywhere felt an online shift during COVID-19. 

    And, while the country gradually recovers from the pandemic, the collective need to stay connected remains stronger than ever. 

    Enter the Affordable Connectivity Program (ACP).

    ACP extends and makes permanent the Internet subsidy for families in need that began under the Emergency Broadband Benefit (EBB) program. Falling under the $1.2T bipartisan Infrastructure Investment and Jobs Act, the ACP is part of a $65 billion broadband Internet initiative designed to bring affordable or even free Internet service to families who qualify.

    Eligible households can save up to $30 a month, or up to $75 if they reside on tribal lands.

    So, who qualifies? Here’s a glance at the different criteria from the FCC of which one or more is required:

  • Household is at or below 200% of the Federal Poverty Guidelines.
  • Participates in certain assistance programs, such as SNAP, Medicaid, Federal Public Housing Assistance, SSI, WIC, or Lifeline.
  • Participates in tribal-specific programs, such as Bureau of Indian Affairs General Assistance, Tribal TANF, or Food Distribution Program on Indian Reservations.
  • Participates in the National School Lunch or Breakfast Program, including through the USDA Community Eligibility Provision.
  • Received a Federal Pell Grant during the current award year.
  • Meets the eligibility criteria for a participating provider’s existing low-income Internet program.

    • Visit fcc.gov/acp for more details and call 844-844-WIFI (844-844-9434) to find a participating provider nearby.

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    A casual stroll by the mysterious deep web

    Guest Commentary by Lakhijyoti Deka

    The "dark web" - sounds like mysterious! Doesn't it?

    Yes, I think your gut feeling says it is, but here I will make you aware how it works, what really happens on the dark web, and how you can check it out for yourself.

    Computer network
    Photo: Matthew Henry/Burst
    As you know, the internet comprises of servers, computers, and other devices connected together form networks inside of larger networks. It is divided into two parts, namely the clear web or surface web and the deep web.

    The surface web is that portion of the Internet most people are familiar with. The surface web pages are searchable in Google. While the deep web comprises the majority of the web, the surface web makes up a tiny portion of all the content on the web that accessible through a standard web browser.

    The Deep Web is the full body of the iceberg and the surface web is just like the tip of the iceberg. And finally the dark web is a very small and hard-to-access section of the Deep Web.

    The dark web is a piece of the internet that isn't indexed by conventional search engines. The dark web is decentralized network of websites make users as mysterious as possible by routing all their communications through multiple servers. It is used for keeping internet activity anonymous and personal, which may be helpful in both legal and illegal applications. Like, anyone can buy master card numbers; counterfeit money, online market place of various drugs, guns, stolen subscription credentials, hacked accounts, password and software that help anyone forced an entry into other people’s computers.


    Dark web browser:

    You may think that navigating the dark net is very easy. But it isn’t. To accessing the dark net it requires a browser known as Tor (“The Onion Routing” project) browser.

    If you have a legitimate need to access the dark web, make sure that you stay safe using it.
    Tor browser provides users access to reach the websites with the “.onion” registry operator. Browsers with the appropriate proxy can reach dark web sites, but others can’t. These web sites use a scrambled naming structure that creates URLs that are impossible to remember often.

    This browser was originally developed by the United States Naval research laboratory. An early version of Tor was created to cover spy communications. Sooner or later, the framework was repurposed and has since been made public just like the other browser we all know today. Anyone can download it free of cost. Tor browser uses a random path of encrypted servers referred to as "nodes" which enables users to connect to the deep web without worrying of their actions being tracked.


    Dark web versus deep web:

    The dark web and the deep web are also often mistakenly used interchangeably. At first glance, the dark web and the deep web seem similar as both are difficult to get to through the web search and require either clicking a direct link to the page or to typing the address into the browser you want to access.

    The deep web refers all the pages or content that you cannot find with a search engine. Deep web content requires sign-in credentials, such as online banking, medical records, pay sites, membership websites, and confidential corporate web pages etc. The dark web is one small portion of the deep web.

    The deep web is so large that it is impossible to discover exactly how many pages or websites are active at one point of time. While comparing the deep web with dark web, deep web consisting of mostly harmless and digitized data and the dark web is better known for illegal and sometimes disturbing content. But, not all the dark web is used for illicit purposes. The websites in the Dark Web are categorized by their use of encryption software that makes their users and their locations unsigned. 


    Enabling mechanisms of the dark web:

    Apart from the tor there are two key elements that serve practical purposes in enabling the dark web. Those two are the Hidden Wiki and Bitcoin, which provide a solution that enables the dark web to be accessible and usable.

    Though the hidden Wiki offers some assistance to content on the dark web, but it also includes some illegal websites.

    Hidden wiki site contains a listing of all the Dark internet sites that are presently operating, user feedback on those sites, and knowledge about what are often accessed through each site. Bitcoin is the crypto-currency which enables two parties to conduct a trusted transaction without knowing each other’s identity. The dark web has been a big factor in the expansion of bit coin and vice versa.


    Advantages of the dark web:

    The legality of dark web is based on how a user engages with it. Some might fall to the edge of legal lines for many reasons and some may act in ways that are illegal for the safety and security of others. Using of the dark web usually means you're attempting to interact in activity that you simply couldn't perform within the limelight.

    Not everything is illegitimate in the dark web. It has a legitimate side also. Privacy is much more concern for many people threatened by stalkers and other criminals. In this case dark web helps people to take care of privacy and freely express their views.

    On the dark web, users can seek out the benefits of the user anonymity, ability to take illegal actions for both users and providers and the virtually untraceable services and sites. In fact, a lot of people use it in countries where internet access is criminalized. As an anonymous communications channel the Tor network serves an important function in helping individuals communicate in environments which are hostile to free speech.

    One of the foremost advantages of the dark web is the difficulty of blocking it. Common forms of censorship do not work with encrypted overlay networks. The dark web is more challenging to surveillance by governments and Internet service providers. Many organizations including journalists, political dissidents, abuse and persecution victims, human Rights and other professionals support the use of and access to the dark web to communicate sensitive information.


    Disadvantages of the dark web:

    The dark web is the den to the criminal activities.

    The most important portion of dark web traffic is child abuse. The vast of traffic to hidden dark sites via Tor is for screening and distributing images of child abuse, illicit pornography and buying illegal drugs. Using the dark web one can make it easier to commit a number of of the worst crimes.

    The grouping of the dark web and crypto currencies supposedly makes it much easier to hire someone to commit a murder or some other illegal activities. While some uses the dark web for their privacy concern and for others it may be the violation to their privacy as the private photos, documents, financial records have been stolen from the dark web.

    The subject that is most commonly associated with the dark web is drug trafficking which is an integral and largest part of dark web marketplaces. Silk Road was one of the largest and most infamous dark web marketplaces till 2013. But the shutdown of Silk Road was not the end of dark web marketplaces. Replacements have sprung up to fill the vacuum selling anything that traders want to put online.

    By nature, the dark web is anonymous and incompetent of discriminating between criminals and common users. There are many dark web sites set up by scammers to avoid the rage of their victims. Many e-commerce sites even exist for a while and suddenly disappear with the money they are holding on behalf of customers.

    Enforcement officials must address this issue by campaigning that maintains the privacy of the typical user while unmasking the criminal. They are getting better at finding and prosecuting owners of sites that sell illegal goods and services. User can easily utilize the Tor in an attempt to pirate copyrighted content from the dark web and share illegal pornography, or engage in cyber terrorism.

    The two specific grey areas of dark Web activity are whistleblowing and hacktivism. Those are not categorized as entirely beneficial, but have some commendable characteristics.


    computer and coffee
    Photo: Sajjad Hussain M/Burst
    If you have a legitimate need to access the dark web, make sure that you stay safe using it. For safe access to the dark net you have to trust your intuition. You have to separate your online role from real life, employ active monitoring of identify and financial theft and you have to avoid downloads of dark web files. You should consider using a secondary non-admin local user account for all daily activities and always restrict access to your Tor-enabled device.

    Be sure to educate yourself on the risks of the dark web before you get mislaid in the dark underbelly. It is smart to be selective about the websites you access if you willing to venture to the dark web. Rather than finding the illegal users one has to find the illegal sites.

    The debate on the dark web is by no means over.

    There are many things in the dark web yet to be known. It is still in progress. As policy-makers move forward, they need to monitor vigilantly the evolution of the dark Web and make sure that enforcement agencies have the resources and legal support to police successfully the dark web. Dark web policy must be thoughtful to strike the balance between the requirements of privacy-minded users and the government’s responsibility to prevent criminality.

    It is always preferable to practice safe internet habits with necessary precautions to protect yourself from the illicit world.

    Lakhijyoti Deka is computer engineer in New Delhi, the capitol city of India. In her free time she likes recite poetry, sing and gathering information latest technology.

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    SNAFUs appear in Biden administration home rapid test rollout

    Photo: Jan Kopřiva/Pexels

    by Hannah Recht & Victoria Knight

    (Kaiser Health News) -- In the past week, the Biden administration launched two programs that aim to get rapid covid tests into the hands of every American. But the design of both efforts disadvantages people who already face the greatest barriers to testing.

    From the limit placed on test orders to the languages available on websites, the programs stand to leave out many people who don’t speak English or don’t have internet access, as well as those who live in multifamily households. All these barriers are more common for non-white Americans, who have also been hit hardest by covid. The White House told KHN it will address these problems but did not give specifics.

    It launched a federally run website on Jan. 18 where people can order free tests sent directly to their homes. But there is a four-test limit per household. Many homes could quickly exceed their allotments — more than a third of Hispanic Americans plus about a quarter of Asian and Black Americans live in households with at least five residents, according to an analysis of Census Bureau data by KFF. Only 17% of white Americans live in these larger groups.

    "There are challenges that they have to work on for sure," said Dr. Georges Benjamin, executive director of the American Public Health Association.

    Also, as of Jan. 15, the federal government requires private insurers to reimburse consumers who purchase rapid tests.

    When the federal website — with orders fulfilled and shipped through the United States Postal Service — went live this week, the first wave of sign-ups exposed serious issues.

    Some people who live in multifamily residences, such as condos, dorms, and houses sectioned off into apartments, reported on social media that if one resident had already ordered tests to their address, the website didn’t allow for a second person to place an order.

    "They’re going to have to figure out how to resolve it when you have multiple families living in the same dwelling and each member of the family needs at least one test. I don’t know the answer to that yet," Benjamin said.

    USPS spokesperson David Partenheimer said that while this seems to be a problem for only a small share of orders, people who encounter the issue should file a service request or contact the help desk at 1-800-ASK-USPS.

    A White House official said 20% of shipments will be directed every day to people who live in vulnerable ZIP codes, as determined by the Centers for Disease Control and Prevention’s social vulnerability index, which identifies communities most in need of resources.

    Another potential obstacle: Currently, only those with access to the internet can order the free rapid tests directly to their homes. Although some people can access the website on smartphones, the online-only access could still exclude millions of Americans: 27% of Native American households and 20% of Black households don’t have an internet subscription, according to a KHN analysis of Census Bureau data.

    The federal website is currently available only in English, Spanish, and Chinese.

    According to the White House, a phone line is also being launched to ease these types of issues. An aide said it is expected to be up and running by Jan. 21. But details are pending about the hours it will operate and whether translators will be available for people who don’t speak English.

    However, the website is reaching one group left behind in the initial vaccine rollout: blind and low-vision Americans who use screen-reading technology. Jared Smith, associate director of WebAIM, a nonprofit web accessibility organization, said the federal site "is very accessible. I see only a very few minor nitpicky things I might tweak."

    The Biden administration emphasized that people have options beyond the rapid-testing website. There are free federal testing locations, for instance, as well as testing capacity at homeless shelters and other congregate settings.

    Many Americans with private health plans could get help with the cost of tests from the Biden administration reimbursement directive. In the days since its unveiling, insurers said they have moved quickly to implement the federal requirements. But the new systems have proved difficult to navigate.

    Consumers can obtain rapid tests — up to eight a month are covered — at retail stores and pharmacies. If the store is part of their health plan’s rapid-test network, the test is free. If not, they can buy it and seek reimbursement.

    The program does not cover the 61 million beneficiaries who get health care through Medicare, or the estimated 31 million people who are uninsured. Medicaid and the Children’s Health Insurance Program are required to cover at-home rapid tests, but rules for those programs vary by state.

    And the steps involved are complicated.

    First, consumers must figure out which retailers are partnering with their health plans and then pick up the tests at the pharmacy counter. As of Jan. 19, however, only a few insurance companies had set up that direct-purchase option — and nearly all the major participating pharmacies were sold out of eligible rapid tests.

    Instead, Americans are left to track down and buy rapid tests on their own and then send receipts to their insurance providers.

    Many of the country’s largest insurance companies provide paper forms that customers must print, fill out, and mail along with a receipt and copy of the box’s product code. Only a few, including UnitedHealthcare and Anthem, have online submission options. Highmark, one of the largest Blue Cross and Blue Shield affiliates, for instance, has 16-step instructions for its online submission process that involves printing out a PDF form, signing it, and scanning and uploading it to its portal.

    Nearly 1 in 4 households don’t own a desktop or laptop computer, according to the Census Bureau. Half of U.S. households where no adults speak English don’t have computers.

    A KHN reporter checked the websites of several top private insurers and didn’t find information from any of them on alternatives for customers who don’t have computers, don’t speak English, or are unable to access the forms due to disabilities.

    UnitedHealthcare and CareFirst spokespeople said that members can call their customer service lines for help with translation or submitting receipts. Several other major insurance companies did not respond to questions.

    Once people make it through the submission process, the waiting begins. A month or more after a claim is processed, most insurers send a check in the mail covering the costs.

    And that leads to another wrinkle. Not everyone can easily deposit a check. About 1 in 7 Black and 1 in 8 Hispanic households don’t have checking or savings accounts, compared with 1 in 40 white households, according to a federal report. Disabled Americans are also especially likely to be "unbanked." They would have to pay high fees at check-cashing shops to claim their money.

    "It’s critically important that we are getting testing out, but there are limitations with this program," said Dr. Utibe Essein, an assistant professor of medicine at the University of Pittsburgh School of Medicine. "These challenges around getting tests to individuals with language barriers or who are homeless are sadly the same drivers of disparities that we see with other health conditions."

    KHN Midwest correspondent Lauren Weber contributed to this report.

    KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

    Subscribe to KHN's free Morning Briefing.

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    Guest Commentary | A person of many companions may soon come to ruin

    by Glenn Mollette, Guest Commentator


    You may have heard this before. I went out to find a friend a none were to be found. I went out to be a friend and found them all around.

    Where do you find friends?

    Your best friends may be your family. You may be close to siblings, cousins, and others related to you. Growing up, I was blessed to be around a lot of aunts, uncles, cousins, grandparents, siblings, and parents. I didn’t have to think much about searching for friends because so many relatives were always around. This is not always the case. Many people have small families or maybe even no family. Some families go in different directions, live in different places, or move on with different interests and lives.

    The Internet and social media have become the world’s biggest connection place.

    We often find friends in school. Some of the people we shared elementary and high school with become lifelong connections. Even if we don’t see each other much, we still have those great past times that help us reconnect quickly.

    We connect with people at our places of employment. Some of the people you spend hours with every day become lifelong friends.

    Houses of faith are often good places to make new friends. People get to know each other in Bible study classes and other small group religious settings. The people you share your faith with will often become like brothers and sisters.

    The local gym is often a place where people socialize. If you become a routine attender of an exercise class you will eventually develop some friends.

    The Internet and social media have become the world’s biggest connection place. To many people this is their only connection. All their “friends” are on Facebook or Instagram. Many people have thousands of social media friends. Too often the loneliest people on the planet are those who are only connected by a keypad.

    There are many more places where you can connect. Many communities have baking, quilting, hunting, sports clubs, and more. Civic groups from Kiwanis, Rotary, and Ruritan groups will often meet weekly and do community projects.

    You might make some friends volunteering at the hospital or nursing home. There will be people in most of these places who will be glad to make a new friend. Talk to your local nursing home about your interest and you may be surprised how quickly your talents are utilized. You will also find some people who will be glad to make a new friend. Keep in mind this is not always easy as you will be trying to make friends with many who feel alone and forgotten.

    You can always become active in the local political circles. This all depends on your level of desperation and if you don’t mind being shunned by whichever party you don’t declare affiliation.

    Don’t try to have too many friends. The Bible says a person of many companions may soon come to ruin. However, you need a few friends and hopefully you will have some good ones.


    -----------------------------------------------------------

    He is the author of 13 books including Uncommom Sense, the Spiritual Chocolate series, Grandpa's Store, Minister's Guidebook insights from a fellow minister. His column is published weekly in over 600 publications in all 50 states. The views expressed are those of the author and are not necessarily representative of any other group or organization. We welcome comments and views from our readers. Submit your letters to the editor or commentary on a current event 24/7 to editor@oursentinel.com.

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    We will learn together: Real Talk with SJO teacher Robert Glazier

    Like thousands of teachers throughout Illinois, veteran St. Joseph-Ogden science teacher Robert Glazier is enriching young minds in an environment they never imagined.

    Glazier, who retired two years ago after a 30 year teaching career at SJO, is teaching two physics classes from his home via video conferencing software. When he began teaching 35 years ago the internet, formally referred to as the world wide web, did not exist. Now he using it as he primarily tool to communicate with students in a virtual classroom.

    The Sentinel caught with one of the student body's favorite teachers and observing strict social distancing fired off five questions with the help of Twitter to get a snapshot on how home teaching was going for long time assistant Spartan football coach.


    Sentinel: Is this the first time you have taught classes via the internet?

    Glazier: Yes.


    Sentinel: Is it easier or harder to teach high school physics via video/web communications software?

    Glazier: Much harder. Physics is a lab class and requires demonstrations, labs and etc. Plus, I enjoy the interaction with students as I lecture. That doesn’t happen as well on line.


    Sentinel: I totally forgot about physic lab experiments. How have you been handling those in the new e-classroom environment?

    Glazier: Honestly, I haven’t. This is all very new to me. I told the kids when this started, we will learn together this way. We will get through it though.


    Sentinel: In numerous Spartan Spotlights students have mentioned your name as one of their favorite high school teachers. It seems you genuinely care about your students and seeing them succeed. What do you enjoy about teaching?

    Glazier: The interaction with them is always fun. They have fresh ideas. New ways of looking at things. I just enjoy being around them.


    Sentinel: Hypothetically, if students have to return to the e-learning environment for classes this fall, and now that you have more experience under your belt, what would you change to enhance their education?

    Glazier: Find more YouTube videos to help with the lectures and lack of labs.



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    Boosting your online security, tips from a convicted hacker

    Photo: Tima Miroshnichenko/Pexels
    by Cezary Podkul
    Ngô Minh Hiếu was once a fearsome hacker who spent 7 1/2 years incarcerated in the U.S. for running an online store that sold the personal information of about 200 million Americans. Since leaving prison, Hiếu has become a so-called white hat hacker, attempting to protect the world from the sorts of cybercriminals he once was.

    These days, Hiếu said, it doesn’t take much hacking to access sensitive details about Americans. Companies and governments routinely leave databases exposed online with little or no protection, as we’ve reported, giving cybercriminals an easy way to harvest names, emails, passwords and other info. While in prison, Hiếu wrote an online security guide for the average internet user. As he and others have pointed out, it’s impossible to create an impenetrable shield. But here are some of his tips for how you can mitigate your risks, along with some other practical online security advice.

    1. Stop reusing passwords

    Make 2022 the year you finally stop reusing passwords. Once a password is exposed in a data breach, as routinely occurs, cybercriminals may use it on other websites to see if it grants them access and lets them take over an account or service. To help you generate lengthy, difficult-to-guess passwords without having to commit them to memory, use an encrypted password manager such as 1Password or LastPass. These services, which typically charge $3 to $4 per month, also monitor databases of breached passwords, like Have I Been Pwned, which can identify some passwords that have already been made public.

    2. Delete unused accounts

    Another benefit of using a password manager is that every time you create a new account at a website, you can log it in your password app. The app will track when you created a password and when you last modified it. If you notice that you haven’t used a website in a few years, and you don’t think you’re likely to use it again, delete your account from that website. It will mean one less place where your data resides.

    3. Add an additional layer of security

    Use multifactor authentication — which requires a second, temporary code in addition to your password to log in to a site or service — whenever possible. Some services send a six-digit code via text message or email. But the most secure method is to use an app that generates a numerical code on your phone that’s in sync with an algorithm running on the site. To make the process easier, you can download an app like Authy that, like a password keeper, helps you generate and manage all your multifactor authentications in one spot.

    4. Manage your apps’ privacy settings

    A lot of the data about us that gets leaked consists of information we don’t even realize apps and services collect. To limit that risk, check the privacy settings for any new app that you install on your computer, smartphone or other device. Deselect any services you don’t want the app to have access to, such as your contacts, location, camera or microphone. Here are some guides on how to manage your apps’ privacy settings for iPhone and Android devices.

    5. Think before you click

    Clicking on a link from a text message, an email or a search result without first thinking about whether it’s secure can expose you to phishing attacks and malware. In general, never click on any links that you didn’t seek out and avoid unsolicited emails asking you to open attachments. When in doubt, hover your cursor over a hyperlink and scrutinize the URL. Avoid it if it would lead you to somewhere you don’t expect or if it contains spelling errors like a missing or extra letter in a company’s name. And for safer online browsing, consider paying for an antivirus tool like Malwarebytes that helps you avoid suspicious URLs online (or sign up for a free browser guard extension).

    6. Keep your software up to date

    Whether it’s your web browser or the operating system on your computer or smartphone, it’s always a good idea to download and install the latest software update as soon as it’s available. Doing so fixes bugs and helps keep your systems patched against the latest security threats. To make sure you don’t forget, turn on notifications for new updates or enable autoupdate settings if they’re available.

    7. Limit what you’re sharing online

    Some of the large collections of personally identifiable information that have been floating around online weren’t hacked or stolen: They were simply scraped from social media websites like LinkedIn or Facebook. If you don’t want a particular piece of info about you out there, don’t put it on your social media profile. Scrub anything you don’t want exposed in your profiles, and check the platforms’ privacy settings to see who can access whatever is left. You can also pay for a service like DeleteMe, which helps centralize and pursue requests to delete your personal information from various data brokers.

    8. Secure your SIM

    One technique that has become increasingly common in recent years is SIM swapping: A cybercriminal tries to dupe your mobile carrier into switching your number from a SIM (the memory card that tells your phone it’s yours) that you control to a SIM that they control. The goal is to commandeer your phone so they can get around multifactor authentication settings that protect your financial accounts. To guard against SIM swaps, contact your carrier to establish an account PIN, or follow these directions if you’re with Verizon, AT&T or T-Mobile. And if you switch carriers, change your PIN.

    9. Freeze your credit reports

    If you’re afraid that a scammer might use your identity to open a fraudulent credit line in your name, consider placing a freeze on your report. A freeze will restrict access to your credit report, meaning that no one (not even you) will be able to open a new credit line while it’s in place. If you decide to apply for a loan or a new credit card, you can always unfreeze your credit later on. Freezing and unfreezing your credit is free, but you have to contact each of the three major credit bureaus separately to do it. Here’s a guide on how to get started.

    10. Back up your data

    Don’t assume that you’ll always have access to all your files and folders. Backing up your data can help you guard against virus infections as well as hard drive failure and theft or loss of your computer. You could use well-known cloud storage providers such as Dropbox or Google Drive to save copies of your data or buy a subscription to an online cloud backup service that automatically saves your files and lets you restore them if anything happens. All such services offer encryption, but if you’re afraid of storing your data in the cloud, keep an encrypted copy on a separate hard drive.

    ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.

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    Viewpoint |
    Bring back normalization with Cuba; the benefits will be well worth it

    President Trump’s decision to roll back our opening with Cuba was disastrous. As he takes office again, he should reconsider.


    Photo illustration: Brigitte Werner/Pixabay

    by Lissa Weinmann
          OtherWords

    Ten years ago, the U.S. and Cuba announced the start of normalization between our two countries. Americans and Cubans alike could see a bit of light through a crack in the wall of U.S. restrictions that, for six decades, have blocked normal interaction between close neighbors.

    The brief opening was largely ceremonial — President Trump rolled much of it back in his first term. And only Congress can truly end the world’s longest running embargo.

    Florida Senator Marco Rubio, President-elect Trump’s pick for Secretary of State, embraces the same old Cold War playbook on the issue: punish Cuba, stoke chaos and civil unrest, and hope the government collapses. As far back as JFK, U.S. officials have been trapped in this irrational family feud that empowers hardliners in both governments while holding citizens here and there hostage to a bureaucratic status quo.

    But it doesn’t have to be that way. Two years of limited opening had a positive impact and was supported by a majority of Cuban Americans. Buoyed by Cuban government reforms and cash from families in the U.S., the island’s private sector boomed. Internet access increased and social media exploded with honest voices. American tourists flocked to the country.

    Then Trump emphatically rolled this progress back — he even added Cuba to the list of “state sponsors of terrorism,” despite a complete lack of evidence.

    Today, after a brief glimmer of hope, Cubans are suffering. Hardliners have stopped the economic reform process. Confusion plagues new leaders transitioning from the Castros’ dominance. The pandemic gutted tourism, while storms and flooding ravaged crops.

    The results have been predictable: An exodus from Cuba has surpassed all migration since the imposition of the embargo in 1962. At least half a million have migrated since the end of Trump’s first term — and more are on the way. The island has lost around 10 percent of its population in recent years, a staggering total.

    We need to break our addiction to this big government policy that displaces people and blocks the rest of us from engaging with our neighbors. Ending the embargo would also open doors for Cuban reformers, dissidents, human rights activists, and religious leaders alike by removing the Cuban government’s excuse for its failures.

    A bipartisan majority in Congress could potentially back a full lifting of the embargo. Gulf Coast states who took the big hit in the 60s when they lost a top trading partner in Cuba could be especially delighted to renew those relations.

    ”In a scenario of unrestricted trade, the aggregate of food and medical exports alone could amount to $1.6 billion with 20,000 associated U.S. jobs,” former International Trade Commission Chair Paula Stern PhD found in a 2000 study presented to Congress. Those numbers could be much higher today.

    There would be other benefits as well.

    Companies like Roswell Park in Buffalo, who had to jump through hoops to bring a groundbreaking Cuban-developed lung cancer vaccine to people in the United States, and other health care companies would finally be able to economically partner with world-class Cuban scientists on new medical advances.

    For Trump, the next steps should be obvious: Avoid bloodshed. Ease the pain. Light the way to a new era in U.S.-Cuba relations.


    About the author:
    Lissa Weinmann is a board member of Windham World Affairs Council. She helped found and direct Americans for Humanitarian Trade with Cuba, a coalition that helped ease the embargo’s restrictions on food sales to Cuba, and directed the National Summit on Cuba. This op-ed was distributed by OtherWords.org.


    More Viewpoints:
    Letters to the Editor
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    The ultimate guide for moving to a college town in Illinois

    PhotoNews Media/Clark Brooks
    .

    SNS - You've got your letter of acceptance in hand for graduate school at the university of your choice or a new job in college town. Are you ready to embark on an exciting adventure in higher education in the coming spring semester or next August?

    Moving to a college town is more than just a change of address. Regardless it you are an incoming freshman, transfer student, or graduate student pursuing an advanced degree, moving to a environment can be a transformative experience. Below is a comprehensive checklist for making that big move to campus and ensuring a seamless transition. This guide was developed with you in mind to help navigate the often-overlooked aspects of college-town life.

    Researching the college

    Embarking on your college journey begins with a crucial step in our checklist for moving to a college town: thorough research. Picture yourself going on an exciting expedition. Arm yourself with the knowledge to make informed decisions. Explore the campus layout virtually. Trace your footsteps from lecture halls to coffee shops, workout facilities and your college team's stadium.

    Next, check out the academic world. What courses resonate with your passions and aspirations? Seek out professors who inspire you and research their work.

    The student union is a great place on campus to meet new people and find organizations that fits your intersts.

    PhotoNews Media/Clark Brooks

    Finally, explore student organizations and clubs, discovering where your interests align. On campus, there is a niche for everyone, from debate societies to club sports teams to cultural clubs. Here, you will make new friends, too, some for life. Overall, your college experience is as unique as you are, and this knowledge empowers you to find the perfect fit.

    Finding suitable housing

    From on-campus dorms to off-campus apartments or rental houses, there's a match for your preferences and budget. Consider proximity to classes, amenities, and transportation. Do you prefer the convenience of walking to campus, or are you open to a short commute? Think about roommates, too, whether you're sharing with friends or going room with a complete stranger. Clear communication and shared expectations make for harmonious cohabitation whether it is your BFF from high school or some you just met.

    Budgeting as part of the checklist for moving to a college town

    Budgeting is the compass that will guide your financial journey as you prepare to move to a college town. Begin by creating a comprehensive and detailed budget that covers all your expenses. Factor in your rent or housing costs, utilities like electricity, water, internet, groceries, transportation, and personal expenses. Don't forget about textbooks, school supplies, and any course-related expenses. Allocate funds for entertainment and leisure activities, too — because, face it, having fun is important.

    Track your spending using apps or spreadsheets to monitor every dollar in and out of your accounts. That helps you stay on top of your finances, preventing calling mom or dad for extra cash when those nasty surprises occassionaly pop up. Consider setting up a separate savings account for emergencies or unexpected costs at a local bank. It's your safety net if things don't go according to plan. Be disciplined and realistic about your budget. Adapt and adjust as you go along, making necessary tweaks to ensure your financial well-being.

    Planning the move to college town

    The first thing you will want to do is create a detailed checklist that outlines every step, from researching housing options to packing essentials. Be proactive and start early to avoid last-minute stress. In addition, consider hiring professional movers, like Beltway Movers Maryland states that this will help your transition go super smooth. It is smart to label your boxes for easy unpacking. Notify your current and future utility providers, if necessary, about your relocation and ensure you have all the necessary services in your new place before arrival.

    At the same time, purge unnecessary items during the packing process. It's a great opportunity to declutter and streamline your belongings. Prepare an essentials box with items you will need right away upon arrival. Include toiletries, clothes, important documents, and any daily necessities.

    Contact potential roommates or neighbors to introduce yourself and establish a connection before moving in. Keep important documents (like your lease, ID, and financial records) organized and easily accessible during the move.

    Public transit is a student's best friend in many college towns like on the campus of the University of Illinois. The MTD system provides transportation throughout the twin city community.
    PhotoNews Media/Clark Brooks
    Getting around town and campus

    Finding housing and transportation before you move is a key part of the checklist for moving to a college town. Will you rely on your car, or is public transportation more your style? Consider the cost, parking availability, and environmental impact.

    If you're considering biking, explore bike-friendly routes and invest in a sturdy lock. It's a fantastic way to stay fit and eco-conscious while getting around.

    Public transit is a student's best friend in many college towns: research bus and subway routes, schedules, and passes. Most colleges offer student discounts that can lighten your financial load.

    Ride-sharing services like Uber and Lyft, provide flexibility without the commitment of owning a car. They are perfect for occasional trips or late-night study sessions. Walking is eco-friendly and a great way to discover hidden gems around your campus.

    Check out the weather

    Start by checking the average temperatures in your college town throughout the year. Will you deal with chilly winters, scorching summers, or mild, temperate weather? Also, rainfall patterns matter. Are you moving to a place with frequent downpours or a more arid climate? Knowing this will help you prepare with the right clothing and gear.

    Also, consider the local terrain. Does your college town experience heavy snowfall, and do you need to prepare for icy sidewalks and roads? Or will you need sunscreen for those sunny days? Keep an eye on the area's weather trends and extreme events. Is it prone to hurricanes, tornadoes, or wildfires? Understanding these risks will also help you prepare and stay safe.

    Weather apps and local news sources are invaluable for real-time updates. Knowing what to expect means you're always ready for whatever Mother Nature throws your way. So, grab your raincoat or sunscreen and embark on your academic journey in style, come rain or shine.

    From researching the college's culture to budgeting wisely, every step of this checklist for moving to a college town contributes to a successful relocation. In your college town, you'll find an academic community and a dynamic environment waiting to be explored. Every experience is a stepping stone toward a bright and promising future, from the classrooms to the local hangouts.

    So, embrace this exciting chapter with enthusiasm and confidence. You're equipped with knowledge and insight to make informed choices, ensuring your college experience is fulfilling and rewarding.

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    Millions of low-income Americans to lose Medicaid coverage as Covid-era restrictions come to an end

    by Phil Galewitz
    Kaiser Health News
    Legislation enacted in December will be phasing out that money over the next year and calls for states to resume cutting off from Medicaid people who no longer qualify.
    States are preparing to remove millions of people from Medicaid as protections put in place early in the covid-19 pandemic expire.

    The upheaval, which begins in April, will put millions of low-income Americans at risk of losing health coverage, threatening their access to care and potentially exposing them to large medical bills.

    It will also put pressure on the finances of hospitals, doctors, and others relying on payments from Medicaid, a state-federal program that covers lower-income people and people with disabilities.

    Almost three years ago, as covid sent the economy into free fall, the federal government agreed to send billions of dollars in extra Medicaid funding to states on the condition that they stop dropping people from their rolls.

    But legislation enacted in December will be phasing out that money over the next year and calls for states to resume cutting off from Medicaid people who no longer qualify.

    Now, states face steep challenges: making sure they don’t disenroll people who are still entitled to Medicaid and connecting the rest to other sources of coverage.

    Even before the pandemic, states struggled to stay in contact with Medicaid recipients, who in some cases lack a stable address or internet service, do not speak English, or don’t prioritize health insurance over more pressing needs.

    “We have no illusion that this will be beautiful or graceful, but we will be doing everything we can not to lose anyone in the process,” Dana Hittle, Oregon’s interim Medicaid director, said of the so-called Medicaid unwinding.

    With the rate of uninsured Americans at an all-time low, 8%, the course reversal will be painful.

    The Biden administration has predicted that 15 million people — 17% of enrollees — will lose coverage through Medicaid or CHIP, the closely related Children’s Health Insurance Program, as the programs return to normal operations. While many of the 15 million will fall off because they no longer qualify, nearly half will be dropped for procedural reasons, such as failing to respond to requests for updated personal information, a federal report said.

    Certain states may be hit particularly hard: Nevada’s enrollment in Medicaid and CHIP has risen 47% since February 2020. Many signed up toward the start of the pandemic, when the state’s unemployment rate spiked to nearly 30%.

    Ordinarily, people move in and out of Medicaid all the time. States, which have significant flexibility in how they run their Medicaid programs, typically experience significant “churn” as people’s incomes change and they gain or lose eligibility.

    The unwinding will play out over more than a year.

    We acknowledge that this is going to be a bumpy road

    People who lose Medicaid coverage — in the more than 30 states covered by the federal marketplace — will have until July 31, 2024, to sign up for ACA coverage, CMS announced on Jan. 27. It’s unclear whether the state-based marketplaces will offer the same extended open-enrollment period.

    Even states that are taking far-reaching action to make sure people don’t end up uninsured worry the transition will be rough.

    In California alone, the state government forecasts that at least 2 million people out of 15 million in the program today will lose Medicaid coverage because of loss of eligibility or failure to reenroll.

    “We acknowledge that this is going to be a bumpy road,” California Health and Human Services Secretary Mark Ghaly said. “We’re doing all we can to be prepared.”

    In an all-hands-on-deck effort, states are enlisting Medicaid health plans, doctors, hospitals, state insurance marketplaces, and an assortment of nonprofit groups, including schools and churches, to reach out to people at risk of losing coverage.

    States will also use social media, television, radio, and billboards, as well as websites and mobile phone apps, to connect with enrollees. That’s in addition to letters and emails.

    Nevada has developed a mobile app to communicate with members, but only 15,000 of its 900,000 Medicaid enrollees have signed up so far.

    “[T]he transient nature of Nevada’s population means that maintaining proper contact information has been difficult,” a state report said in November. At least 1 in 4 letters sent to enrollees were returned on account of a wrong address.

    The law that allows states to begin disenrolling ineligible Medicaid recipients on April 1 bars states from disenrolling anyone because mail was returned as undeliverable until the state has made a “good faith effort” to contact the person at least one other way, such as by phone or email.

    To further reduce disruption, the law requires states to cover children in Medicaid and CHIP for 12 months regardless of changes in circumstances, but that provision doesn’t take effect for almost a year.

    States will give Medicaid recipients at least 60 days to respond to requests for information before dropping them, said Jack Rollins, director of federal policy at the National Association of Medicaid Directors.

    States will use government databases such as those from the IRS and Social Security Administration to check enrollees’ income eligibility so they can renew some people’s coverage automatically without having to contact them. But some states aren’t taking full advantage of the databases.

    States have until February to submit their unwinding plans to the federal Centers for Medicare & Medicaid Services, which will monitor the process.

    We want to make it easier to say yes to coverage

    But it is already clear that some states are doing much more than others to keep people insured.

    Oregon plans to allow children to stay on Medicaid until age 6 and allow everyone else up to two years of eligibility regardless of changes in income and without having to reapply. No other state provides more than one year of guaranteed eligibility.

    Oregon is also creating a subsidized health plan that would cover anyone who no longer qualifies for Medicaid but has an annual income below 200% of the federal poverty level, which amounts to about $29,000 for an individual, state officials said. The program will have benefits similar to Medicaid’s at little or no cost to enrollees.

    Rhode Island will automatically move people who are no longer eligible for Medicaid — and with annual incomes below 200% of the poverty rate — into an Affordable Care Act plan and pay their first two months of premiums. State officials hope the shift will be seamless for many enrollees because they’ll be moving between health plans run by the same company.

    California will move some people to a subsidized private plan on the state’s marketplace, Covered California. Enrollees will have to agree and pay a premium if they don’t qualify for a free plan. However, the premium could be as low as $10 a month, said Jessica Altman, executive director of Covered California. (Altman’s father, Drew Altman, is president and CEO of KFF. KHN is an editorially independent program of KFF.)

    “We want to make it easier to say yes to coverage,” Altman said.

    But experts worry about what will become of Florida Medicaid enrollees.

    Florida doesn’t have its own ACA marketplace. As in most states, its residents use the federal exchange to shop for ACA plans. As a result, the handoff of people from Medicaid to marketplace may not be as efficient as it would be if it involved two state agencies that regularly work together, said Jodi Ray, director of Florida Covering Kids and Families, a nonprofit that helps people find coverage.

    Another concern for advocates is that Florida makes less use of government databases than other states to check enrollees’ incomes. “We make everyone jump through hoops to get reenrolled instead of utilizing all the acceptable data,” Ray said.

    Florida typically takes weeks to process Medicaid applications, while some states do it in a day, she said.

    Florida’s unwinding plan illustrates the difficulty of reaching enrollees. The plan said that, since 2020, the state has identified 850,000 cases in which Medicaid recipients did not respond to requests for information.

    Florida Medicaid officials did not return calls for comment.

    While state officials struggle to manage the unwinding, health care providers are bracing for the fallout.

    Dennis Sulser, chief executive of Billings, Montana-based Youth Dynamics, which provides mental health services to many children on Medicaid, expects some will lose coverage because they get lost in the process.

    That could leave patients unable to pay and the nonprofit financially stretching to try to avoid children facing an interruption in treatment.

    “If we had to discharge a child who is in our group home care, and they're only halfway through it and don't have all of the fundamentals of the care support needed, that could be tragic,” Sulser said.

    KHN correspondents Daniel Chang in Hollywood, Florida; Angela Hart in Sacramento, California; Katheryn Houghton in Missoula, Montana; Bram Sable-Smith in St. Louis; and Sam Whitehead in Atlanta contributed to this report.

    KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
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