Just before the Thanksgiving holiday, the Federal Communications Commission released its plan to gut net neutrality, also known as the equal flow and access to all content and services on the Internet.

Calling it a “light-touch regulatory framework,” FCC Chairman Ajit Pai wrote in a Wall Street Journal editorial on Nov. 21 that the proposed changes would undo Obama-era rules that regulated the Internet “like a 1930s utility.”

However, most Internet companies and consumer advocates support the Obama-era FCC rules, which enshrined protections of a free and open Internet in 2015.

On Dec. 14, the FCC’s five commissioners are scheduled to vote on Pai’s proposal overturning the 2015 rules. At this point, the vote is expected to go 3-2 in favor of the proposal, along party lines. You can find the meeting agenda here.

As I’ve previously written, an end to net neutrality has implications for both media organizations and health care providers. That is because without net neutrality, Internet service providers (ISPs) such as telecom giants Comcast, AT&T and Verizon could block or throttle Internet access. They could create “fast lanes” and collect tolls from companies (such as hospitals, telehealth providers, media companies and startups) to have their websites load quickly. Comcast has said it will not do this, but many observers are skeptical. Josh Brodkin at Ars Technica nicely lays out this possible future of “paid prioritization” in this article.

FCC Commissioner Jessica Rosenworcel, who opposes the Pai proposal, wrote an op-ed in the Los Angeles Times urging the public to “stop us from killing net neutrality.”

“There is something not right about a few unelected FCC officials making such vast determinations about the future of the internet,” Rosenworcel wrote.

New York State Attorney General Eric Schneiderman revealed on Nov. 21 that his office has been investigating the FCC for the past six months over what he described as a “massive scheme to corrupt the FCC’s notice and comment process.” This involved submission of suspect comments that supported the proposal gutting net neutrality using fake names and addresses or misusing real names and addresses. The Government Accountability Office also is investigating whether people who legitimately sought to comment on the Pai proposal were unable to do so.

So what happens next? Some activists are urging citizens to call their representatives in Congress and demand a legislative solution to preserve net neutrality (bills in prior years didn’t go anywhere). Others are asking the FCC to slow down the process and hold open and transparent hearings around the country. Others are planning lawsuits to challenge the FCC rule.

If the FCC approves Pai’s proposal, states could also seek to enact their own rules. Officials in New York and California already are drafting bills, writes Tali Arbel of the Associated Press. The FCC has said its rules will pre-empt state law, but that view likely will be challenged in court too.

Earlier coverage

• Could ending net neutrality ruin Cyber Monday?, The Verge
• Defending the open internet, Electronic Frontier Foundation
• Video: Why you should care about net neutrality, Wired
• Dear Aunt Sadie, please step back from the net neutrality ledge, Forbes

Rebecca Vesely is AHCJ's topic leader on health information technology and a freelance writer. She has written about health, science and medicine for AFP, the Bay Area News Group, Modern Healthcare, Wired, Scientific American online and many other news outlets.