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Access to health care services and the affordability of health insurance are crucial to overall well-being. However, these vary widely across the United States, with West Virginia painting one of the grimmest pictures. Despite success in getting residents insured, the state’s health outcomes are among the worst in the nation.

According to West Virginia Watch, a national survey ranked West Virginia’s healthcare system dead last in overall outcomes, despite being sixth for accessibility. The state faces the highest rate of preventable deaths, with 126 preventable deaths per 100,000 residents. The mortality rate from diabetes is similarly staggering, reflecting deep-rooted issues in health care infrastructure and accessibility. Even more alarming is that West Virginians pay the highest average private health insurance premiums in the U.S., at around $8,546 per year.

The Cost of Health Care in West Virginia

For one of the poorest states in the country, the cost of health care in West Virginia is a crushing burden. This financial strain acts as a significant barrier, preventing many from accessing essential services. However, there is some good news on this front: the Advanced Premium Tax Credits (APTC) from the American Rescue Plan and the Inflation Reduction Act have helped alleviate some of this pressure.

More than 21,000 West Virginians benefit from these tax credits, saving the average enrollee an estimated $700 in 2024. This relief has been a lifeline, especially for those unable to afford health coverage on their own. Thanks to these credits, a record 21.4 million people signed up for Affordable Care Act (ACA) marketplace coverage in 2024, nearly double the number from 2021.

The Bigger Picture: Social Determinants of Health

West Virginia's alarming health statistics cannot be understood without recognizing the broader context. Social determinants of health—factors like where people are born, live, work, and age—can influence up to 80% of a person’s health before any medical intervention. Unfortunately, the Mountain State faces unique challenges that exacerbate these factors, negatively affecting overall health outcomes.

West Virginia is home to one of the worst drug crises in the country, high obesity rates, and a disproportionately high rate of disability. These issues, combined with one of the lowest labor participation rates, create a vicious cycle of poor health, social isolation, and poverty. Nearly two-thirds of West Virginians live in underserved rural areas, further complicating access to adequate healthcare.

Additionally, population decline and an aging demographic—West Virginia has the nation’s third-highest percentage of residents aged 65 and older—put additional strain on the healthcare system and the economy. With a dwindling workforce, fewer people have the discretionary income needed to support local businesses, creating a ripple effect that impacts the entire state.

The Path Forward: Addressing Systemic Issues

The issues facing West Virginia's health care system are vast but not impossible. Addressing social determinants of health must be a priority, particularly for Medicaid populations and at-risk communities. Expanding Medicaid coverage, promoting competition among insurers, and enhancing preventive care measures are vital steps toward improving outcomes.

However, none of these reforms will be possible without electing leaders who are committed to solving this crisis. Lawmakers need to understand the unique challenges West Virginians face and be willing to champion policies that will improve access, affordability, and outcomes in the state's healthcare system.

West Virginia's healthcare system is at a crossroads, and the choices we make today will determine the well-being of future generations. It's time to address these systemic issues head-on, ensuring every resident has access to the care they deserve.