In an evolving health landscape, emerging research continues to highlight concerns that could impact everyday wellbeing. Here’s the key update you should know about:
Standing atop Ferry Butte, Frances Goli scanned the more than half a million acres of Shoshone-Bannock tribal land below as she dug her hands into the pockets of a pink pullover.
The April wind was chilly at one of the tribes’ highest vistas in remote southeastern Idaho.
“Our goal is to bring fiber out here,” Goli said, sweeping one hand across the horizon. The landscape below is scattered with homes, bordered in the east by snowcapped mountain peaks and to the west by “The Bottoms,” where tribal bison graze along the Snake River.
In between, on any given day, a cancer patient drives to the reservation’s casino to call doctors. A young mother asks one child not to play video games so another can do homework. Tribal field nurses update charts in paper notebooks at patients’ homes, then drive back to the clinic to pull up records, send orders, or check prescriptions.
Three years ago, the Shoshone-Bannock Tribes were awarded more than $22 million during the first round of the federal Tribal Broadband Connectivity Program. But tribes that were awarded millions in a second round of funding saw their payments held up under the Trump administration. Last month, federal leaders announced modifications to tribal broadband programs as part of a larger effort to “reduce red tape.” The National Telecommunications and Information Administration said it plans to “promote flexibility” and launch a new grant in the spring.
Federal regulators declined to provide details. The announcement comes after a year of upheaval for federal broadband programs, including the elimination of Digital Equity Act funding, which President Donald Trump has called “racist,” and a restructured $42 billion Broadband, Equity, Access, and Deployment program, which U.S. Commerce Secretary Howard Lutnick said was influenced by “woke mandates.”
Across Indian Country and on the Fort Hall Reservation, high-speed internet service gaps persist despite billions set aside for tribes. In early November, U.S. Sens. Maria Cantwell (D-Wash.) and Brian Schatz (D-Hawaii) asked federal agency leaders why funds already awarded had not been released to tribes and whether federal regulators were providing adequate technical assistance.
So far, the $3 billion tribal program has announced $2.24 billion in awards for 275 projects nationwide. But tribes that won awards have drawn down only about $500 million, according to a recent update from the Commerce Department’s Office of Inspector General.
The agency has initiated tribal consultation on the broadband programs, offering tribal leaders two dates in January for online meetings.
The Shoshone-Bannock Tribes have drawn down less than 2% of their awarded funding and the program has not yet connected a single household, Goli said. NTIA spokesperson Stephen Yusko said the Shoshone-Bannock Tribes are still slated to get their full grant award and, he confirmed, future spending will not be subject to the administration’s recalibrations.
Gaps in high-speed internet can be profound and urgent on tribal lands. Tribal members are historically underserved and, on average, live with the highest rates of chronic illnesses and die 6.5 years earlier than the average U.S. resident.
Diabetes and high suicide rates are among the most pernicious tribal health challenges — and federal research confirms telehealth can improve health outcomes. A KFF Health News analysis showed that people tend to live sicker and die younger in America when they live in dead zones, or places where poor internet access intersects with shortages of health care providers, leaving patients who need it most unable to use telehealth.
“We’re in survival mode,” said Nancy Eschief Murillo, a longtime Shoshone-Bannock leader. The tribes, which have an on-site clinic, need more health care both in person and with telehealth, she said. “Right now, our reservation? We don’t have accessibility.”
‘Not 100% accurate’
Inside a trailer that serves as the temporary headquarters for Fort Hall’s tribal broadband office, Goli sat at a desk in June and scanned the Federal Communications Commission’s most recent online map of the reservation.
As the tribes’ broadband project manager, Goli didn’t like what she saw on the map. Blue hexagons highlighted varying rates of high-speed coverage and signified that high-speed internet is available on much of the reservation. Companies have told federal regulators they provide fast transmission speeds to homes there.
“These are untrue,” Goli said. Fort Hall has about 2,400 households, and nearly all of them live without high-speed internet, she said.
When it comes to tracking who on a reservation has high-speed internet, “everybody acknowledges, including the FCC, that the map is not 100% accurate,” said Robert Griffin, co-chair of the Fiber Broadband Association Tribal Committee, an industry trade group. He is also the broadband director for the Choctaw Nation of Oklahoma.
Attempting to correct the maps is one of the many tasks Goli has taken on since becoming the Shoshone-Bannock Tribes’ broadband project manager in January 2023 — seven months after the tribes won the award.
A series of hurdles, including flaws in the plan initially approved by the federal government and a cyberattack, have delayed the project, she said. The attack hit in August 2024 and for months shut down nearly all phones and computers on the reservation.
“We didn’t have access to any of our information,” Goli told KFF Health News this month, adding that the tribes are still “in recovery mode” from the attack.
Goli, who grew up on the reservation and still plays basketball at the tribal gym, left her job as a data analyst in Seattle to return home to be with family and to work. For two years, and with no broadband industry experience, Goli has overseen the multimillion-dollar grant without a staff.
Her first task, she said, was to collect data that could help create a realistic plan to deliver broadband to every home on the reservation. “Data tells a story,” Goli said.
Edmo lives about half a mile from the Fort Hall townsite and said he can’t really use his internet because he “gets a tremendous amount of buffering.” When he travels to doctors for his prostate cancer treatment, Edmo has them print paper schedules to keep track of his treatment.
He said he is not a big fan of telehealth, “probably because I don’t know how to use it.”
For 53-year-old Carol Cervantes Osborne, who also lives on the reservation, having internet is a necessity. Osborne is in constant pain from severe rheumatoid arthritis.
“I’m just all broke down,” Osborne said as she stared at the open pasture last June. She talked about how she misses riding cattle roundups. At times, Osborne has been bed-bound because of her arthritis and bad knees. She said she tapped her credit line, which uses land and cattle as collateral, and signed up for Starlink so that she can connect with doctors remotely through telehealth appointments.
“I’m poor because of it, but we’ve got to have it,” Osborne said.
Meanwhile, nearly 15 months after the cyberattack, Goli said the tribes are beginning to hire vendors.
“Things happen very slow when it comes to processing things in the tribal government,” Goli said, adding there are a lot of “checks and balances.”
This month — as the holidays approached — Goli said she was excited.
“We’ve actually started our first segment of fiber,” Goli said. The engineering work is done, and they have begun issuing permits, she said. The fiber-optic lines, built by a private vendor, will cover a two-mile segment on the northern end of the reservation. The line will come from outside the reservation and connect to the tribes’ data hub, which is an old radio station still being converted into broadband offices.
“It’s our first segment, and we’re really using this as a test,” Goli said.
Eventually, the old radio station will be central to operations, with fiber-optic cable lines that web out over about 800 square miles to reach the reservation’s five district lodges. Each lodge will establish a communications tower, which will use the fiber line to power wireless antennas that will then provide high-speed internet to the reservation’s most remote homes.
Goli said the tribes are applying for another extension — and, she said, they would not be the only award winners of the Tribal Broadband Connectivity Program to ask for more time. Working with tribes, she said, takes time.
“It really saddens me that we’ve been left behind all these years,” Goli said, but “this is our opportunity. We want to do it right, slow and steady.”
Sarah Jane Tribble, KFF Health News’ chief rural correspondent, spent more than a year interviewing Frances Goli through calls, texts, and emails. She traveled to Fort Hall Reservation twice, having received tribal approval to visit the land: in spring 2024 and again in summer 2025. Tribble also reviewed publicly requested copies of the tribal contract and interviewed dozens of industry and regulatory broadband experts.
