Lots of hills and low population density. I bet it is hard to get good internet in Vermont. Universal access to broadband would matter more than anything else.
Vermontel is rolling out gigabit fiber to all of vermont. I already have it in my seriously rural house in southern vt. It's faster and cheaper than any residential internet I have had in NYC.
It can be but its much better then it was 5 years ago even in smaller towns. My office is on fiber. My house has 50 mbit cable that is quite reliable and never over subscribed. Friends that live several miles out dirt roads have either satellite, dsl, or, increasingly often, LTE or Wifi-based service. LTE/Wifi/Cable and fiber all have plenty > 25Mbit options (up to 1GB most of the time) and even DSL and satellite do fine for NetFlix etc.
It's easy if you live quite close to:
Burlington, Rutland, Barre, Montpelier, Winooski, St. Albans
and otherwise a matter of luck.
Those are the top six cities by population, and the top two put together are about the same as my suburb of Boston. St. Albans is about 30 minutes from Burlington and an hour and a bit from Montreal; you can get access to culture and technology, but you'll need to drive.
There's certainly quite a few other areas with decent internet, at least if you are in the main "town" area. Bennington, WRJ + Norwich come to mind as other examples I can think of.
But yes, if you are in a random small town or rural area the odds aren't great for decent internet. (For that matter, that even applies to cell phone service, lots of dead zones in VT).
I was at someone's house/trailer a few weeks ago and he had satellite internet. I have no idea what the upload speeds are like, but we spent most of the time watching YouTube videos and it was at least as good as my DSL at home (I live about 10 miles outside town).