In their own words: West Virginia's uninsured ages 50-64

Background: A series of six focus groups were conducted at locations around West Virginia in support of a HRSA State Planning Grant Demonstration received by the West Virginia Health Care Authority,

Objective: To learn more about the needs and the problems of the uninsured age 50 to 64 in West Virginia.

Methodology: Sites were chosen based on high numbers of uninsured 50 to 64 year olds that had experienced significant increases in uninsurance rates between 2001 and 2003. Eligible participants, uninsured, ages 50-64, were recruited using various methods including, but not limited to, flyers posted at area Community Health Centers and free clinics.

Results: Fifty-five individuals participated in the focus groups. Participants were evenly distributed by age group (50-54, 55-59, and 60-64). Four participants were African American, one Latina, and the remainder Caucasian. 43.5% of participants were employed, 56.4% were unemployed. Of the unemployed, 33% were disabled, 22% retired, 33% homemaker/caretakers, and 13% laid-off. Income was minimally correlated with employment in this group of participants.

Themes: 1) A relationship with a provider, a physician, or a dentist mitigates the difficulty of receiving care but does not eliminate all of the difficulties, specifically, paying for care. 2) Having a free clinic or a 330-funded clinic mitigates the difficulty associated with payment for care. 3) Respondents take advantage of existing programs for prevention and for pharmaceuticals; however, some can't afford to pay even small amounts. 4) Affordability is the primary reason respondents do not have health insurance. 5) Participants perceived lack of sensitivity of providers and sometimes the quality of care they are receiving as a source of frustration: 6) Universal healthcare was mentioned by each group as a response to the problem, although not necessarily a system that was free to everyone. Discussion: Being uninsured is an emotional subject for these participants. There is considerable fear associated with losing their job, their homes, and their assets if they were to become severely ill. Like the majority of state efforts to address the problems of the uninsured, West Virginia asked what people want from an insurance product. What these near elderly uninsured participant from all walks of life requested is an insurance product that meets their health care needs, and is affordable according to their financial circumstance. Unfortunately, in this poor, rural state none of the products being developed meet both of these needs.