In Iowa, at least, the state had a pre-existing fiber network that got expanded to a shit-ton of rural communities and local (often municipal) ISPs. It's more expensive than what you'd get in the cities, but much better bang for buck than Starlink.
The only people still struggling to get service are those who live way, way outside those communities -- the kind of people for whom "neighbor" means somebody who lives a significant fraction of a mile away. And, outside of comfortably wealthy individuals, those people are a dying breed, at least in Iowa.
If Iowa of all places can pull something like that off, I figure it's not out of reach of any state (or nation, for that matter) whose inhabitants give a nano-fuck about access to technology.
*since 2020.
If my cowboy math is correct (assuming two parents and two children), that comes out to about 292 people per year or 876 since 2020.
With a population the size of the United States (330 million), that means that, for a given year, 0.00009% (rounded up) of that population dies as a result of a family annihilation. For comparison, around 40,000 people (including around 1,000 children) die in vehicle accidents annually in the US.
Not that family annihilations aren't horrible. They are. But, from a purely statistical perspective, there are much more frequent horrible things that we don't talk about as much, for a variety of reasons.