Access to medical care is an important goal of health care reform. In West Virginia, access to care has been defined in terms of insurance coverage and the availability of health care professionals, especially primary care practitioners. In recent years, three surveys have attempted to measure access to care. These surveys show that approximately 200,000 to 230,000 West Virginians needed medical care but were not able to obtain it because they could not afford it. A much larger number, about 540,000 West Virginians, put off or postponed seeking care they felt they needed because they could not afford it.