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Billions of dollars have been poured into telehealth during the pandemic: Insurers loosened the purse strings on virtual appointments, digital health companies pulled in astronomical investments, and the public markets minted multiple unicorns.

But while virtual care’s proponents are fighting to cement its future, many Americans still can’t sign on at all.

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Nearly a quarter of adults in the U.S. don’t have broadband at home, network speeds are insufficient for video calls in much of rural America, and 15% struggle to pay for internet. It’s a persistent issue that threatens to hamper the lofty promises made by telehealth startups and policymakers — that virtual care can chip away at long-running inequities in health care, especially those that impact low-income, rural, and Black and Hispanic patients, who are also less likely to have broadband. And while the value and effectiveness of telehealth is still being determined, it’s clear that the gaping disparities in access to health care will only grow wider if the problem isn’t fixed.

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