People on Medicare spent $3.4 billion out of pocket last year on the 10 drugs selected Tuesday for Medicare price negotiations. (iStock | Getty Images Plus)
Access to health care services and the affordability of health insurance are crucial to overall health but vary widely across the United States. Factors including health insurance enrollment, adult wellness visits, health care affordability and Medicare quality are considered to score states across the country, and here in the Mountain State, the results are abysmal.
While West Virginia has done a great job in getting its residents insured, boasting one of the lowest health care uninsured rates per capita in the country, it’s clear the same cannot be said about the state’s health outcomes.
According to a recent national survey, West Virginia has the worst health care in the nation. West Virginia ranks No. 6 for accessibility; yet it has the worst health outcomes of any state, with the highest rate of preventable deaths, 126 preventable deaths per 100,000 residents, and diabetes mortalities. It also has the highest average private health insurance premiums in the U.S. averaging around $8,546 per year.
West Virginia’s troubling rate of preventable deaths serves as a stark reminder of the urgent need for comprehensive health care improvements. Ranking at the top with the highest rates of preventable deaths per 100,000 residents, the state bears witness to avoidable tragedies that signify underlying systemic issues within its health care infrastructure. Enhanced preventive care measures, focused public health campaigns, and timely access to high-quality health care services are vital components in reducing the burden of preventable deaths and enhancing the overall well-being of West Virginians.
In one of the poorest states in the country, the cost of health care in West Virginia weighs heavily on its residents. This financial strain creates significant barriers to accessing essential health care services and threatens the financial stability of individuals and families.
One bit of good news regarding cost is the Advanced Premium Tax Credits (APTC), enacted in the American Rescue Plan and extended by the Inflation Reduction Act, have helped millions of people afford health coverage in the Affordable Care Act (ACA) marketplaces.
Here at home, over 21,000 West Virginians benefit from those tax credits — saving the average enrollee an estimated $700 in 2024. These tax credits are a lifeline for West Virginians who would otherwise not be able to afford their health coverage or access health care.
By making health insurance more affordable, the APTC enhancements helped drive a record 21.4 million people to sign up for marketplace coverage in 2024. This is nearly twice as many as in 2021, when only 12 million people enrolled.
I first enrolled in the ACA in late 2022. I must admit, I was skeptical. It has turned out to be an exceptional option. For people who may be looking for coverage in between jobs with employer sponsored health care, or for individuals working for themselves or small employers who cannot afford a group plan, the ACA Marketplace boasts affordability and flexibility.
The enhanced premium tax credits are set to expire after 2025. If congress does not extend the tax credits, this assistance will be cut and tens of thousands of West Virginians will face losing their health insurance, delaying or skipping needed health care or taking on medical debt they can not afford.
Mitigating the burden of health care costs requires innovative approaches, including promoting transparency, exploring options for expanding Medicaid coverage, and fostering competition among insurance providers.
However, we can’t continue to ignore the big ailing elephant on life support in the room. In order to really address West Virginia’s poor health care outcomes, we have to dig a little deeper and address the unique challenges facing Mountaineers.
Social determinants of health — where people are born, grow, live, work and age — can affect up to 80% of an individual’s health outcomes before any health care intervention occurs.
West Virginia has a unique set of challenges negatively driving social determinants of health, especially at-risk populations, including one of the worst drug problems in the country; high rates of obesity, diabetes, and disability resulting in one of the lowest rates of labor participation — also a contributing factor to social isolation; and a predominantly rural population where two-thirds of all West Virginians live in underserved and under resourced rural communities.
Additionally, population decline is driving an aging state population. West Virginia has the nation’s third highest percentage of state population age 65 and older. This can become a stressor on the workforce that feeds many other issues. It’s hard to support businesses if you don’t have people with discretionary income, so the economy goes sideways.
Addressing social determinants of health can be especially important in removing barriers and improving health for Medicaid populations, but an understanding of West Virginia’s specific challenges is equally vital to achieving success.
West Virginia’s health outcomes paint a bleak picture of the state’s overall well-being. These shocking figures demand immediate attention to address the systemic issues that hinder preventive measures and access to essential health care services. West Virginia’s population deserves a robust, diversified health care system capable of delivering improved outcomes and well-being.
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