Today, living in western Virginia means facing a slew of economic, infrastructural and health gaps. The region is stricken by poverty — the 11 poorest counties and localities in Virginia are exclusively located in the western half of the state, where over 20 percent of the population lives under the poverty line. The region is also plagued by poor infrastructure, as insufficient roads and limited broadband internet access can isolate residents, deepening economic separation. What is worse, the physical well-being of western Virginians is at serious risk due to a lack of healthcare facilities in rural areas. Someone living in Wise, a rural county in southwestern Virginia, can expect to live almost 14 years less than someone living in Fairfax County.
This reality is only set to get worse after newly-effective Trump administration cuts to Medicaid and Medicare reimbursement rates, which will take away about $2 billion a year from Virginia hospitals. A state report found that these cuts will put dire strain on many rural hospitals, over half of which are located in Western Virginia. Without nearby hospitals, rural Virginians will be forced to travel exorbitant distances to receive possibly life-saving care — Virginia Mercury reported that Penny Blue, a resident of Franklin County who suffered a brain aneurysm in 2021, was able to receive crucial timely care after being airlifted from her local rural hospital 15 minutes away, rather than having to drive an hour to Roanoke. The only available path forward to save Virginian lives is for the Virginia General Assembly to take on this crisis and finally provide adequate protection to the people of western Virginia.
The General Assembly has repeatedly failed to take the necessary steps to safeguard western Virginia over the last several decades. Take the example of water-sucking data centers, where the General Assembly has taken little action to restrict new development despite the arid region being in a drought that is threatening drinking water supply. In one instance, Google plans to build the eighth largest data center complex in the world in Botetourt County, a western county currently facing severe drought.
Or look at the Coalfields Expressway, a transformational road project meant to connect and revitalize southwestern Virginia that began in the 1990s. More than 30 years later, it has continued to face significant funding shortages and remains unfinished, further isolating the rural area. In fact, inaction regarding western Virginia has become almost compulsive among Virginia’s politicians. Reacting to the federal cuts that threaten rural hospitals, House Health and Human Services chair Del. Rodney Willett (D-Henrico) did not offer any concrete plan, but deflatingly surrendered, “The facts are the facts and what’s being done to us by Washington is unconscionable.”
Waving the white flag does not lift anyone out of poverty or save any lives — action does. The General Assembly must first act swiftly to offset the Medicare and Medicaid cuts as best it can, safeguarding rural hospitals from closure. A positive initial step has already been taken, as Virginia established a $350 million Medicare Reserve Fund this summer to lessen the blow of the cuts. However, now that the full impact of the cuts have been revealed, the fund is clearly not enough. Utilizing the nearly $1 billion budget surplus from the 2026 fiscal year, Virginia can afford to plug more of the holes left by cuts, either by directly injecting money into floundering rural hospitals or funding innovative programs meant to bring healthcare to underserved areas.
A local illustration of this is U.Va. Health’s mobile clinics, which expand primary care availability for underserved Virginians by bringing healthcare straight to rural areas on a regular basis. The program is a perfect example of an inventive, likely cost-effective approach to healthcare that the General Assembly would be wise to pursue. Ultimately, though, nothing can fully replace the value of an accessible local hospital, and the General Assembly should prioritize supporting the survival of the threatened hospitals, rather than entirely deferring to small-scale programs.
Beyond protecting western Virginians from immediate hospital closure, the General Assembly must also modernize the region, bringing its infrastructure up to speed and making it an attractive area to live and do business in. Attracting more jobs and residents are key to improving the area, which is nearly impossible to do without adequate infrastructure — a 2025 study conducted by ATCS about the Coalfields Expressway found that “limited mobility … and aging roadway infrastructure present significant barriers to long-term regional competitiveness.” By focusing on building up human infrastructure — such as hospitals, roads and water distribution systems — rather than greenlighting destructive private infrastructure as we have seen with data centers, the General Assembly could turn western Virginia into a place that people and businesses alike will be happy to reside in.
The General Assembly has thus far been woefully idle and ineffective in defending western Virginia. This deficiency has deeply hurt the hundreds of thousands of residents of the western half of the state — it has squeezed their pocketbooks, taken years off their lives and devastated their communities. However, this new rural hospital crisis provides a golden opportunity for the legislative body to turn a new leaf and finally take seriously the problems plaguing the western half of the state, hopefully building a better future for it in the process. Each elected official in the Commonwealth of Virginia has a duty to protect the residents of Virginia — it is time that duty be extended to western Virginia.
The Cavalier Daily Editorial Board is composed of the Executive Editor, the Editor-in-Chief, the two Opinion Editors, two Senior Associates and an Opinion Columnist. The board can be reached at eb@cavalierdaily.com.
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