This story by Sarah Jane Tribble, Holly K. Hacker, and Lydia Zuraw appeared on KFF Health News on May 14, 2025. We are sharing it in two parts.
A few miles from Upper Mud River Road, past the McDonald’s and across the road from the local library, Brian Vance sat in his downtown Hamlin, West Virginia, office. He said his company has been trying to “build up there for a while.”
Vance is a general manager for Armstrong Telephone and Cable, a regional telecommunications provider that competes with Frontier. He grew up in the community, and parents of a high school friend live off Upper Mud River. But he said “it’s very difficult” to build fiber along the rocky terrain to homes where “you are hoping that people will hook up, and if they don’t, well, you’ve lost a lot of money.”
A 2022 countywide broadband assessment found that stringing fiber-optic lines along telephone poles would cost more than $5,000 per connection in some areas — work that would need big federal subsidies to be feasible.
Yet Vance said Armstrong cannot apply for the latest BEAD funding to help finance connections. And while he likes that the federal government is “being responsible” by not handing out two federal grants for the same area, Vance said, “we want to see people deliver on the grants they have.”
If Frontier hadn’t already gotten federal funds from the earlier Trump program, “we definitely would have applied to that area,” Vance said.
The 2022 assessment noted the community’s economy would not be sustainable without “ubiquitous broadband.”
High-speed internet brings more jobs and less poverty, said Claudia Persico, an associate professor at American University. Persico, who is also a research associate with the National Bureau of Economic Research, co-authored a recent paper that found increased broadband internet leads to a reduction in the number of suicides as well as improvements in self-reported mental and physical health.
More than 30% of Lincoln County’s population reports cases of depression, according to data from the Centers for Disease Control and Prevention. The rate of opioid prescriptions dispensed in Lincoln County is down about 60% from 2014 to 2024 — but still higher than the state average, according to the West Virginia Board of Pharmacy.
Twenty percent of the county’s population lives below the poverty line, and residents are also more likely than the national average to experience heart disease, diabetes, and obesity.
Lincoln Primary Care Center offers telehealth services such as electronic medical records on a patient portal and a pharmacy app, said Jill Adkins, chief quality and risk officer at Southern West Virginia Health System, which operates the clinic.
But because of limited access, only about 7% of patients use telehealth, she said.
Della Vance was a patient at the clinic but said she has never used a patient portal. If she could, Vance said, she would check records on the baby she is expecting.
“You can’t really get on if you don’t have good service and no internet,” she said. “It makes me angry, honestly.”
Vance and her husband, Isaiah, live off a gravel road that veers from Upper Mud River. There is a tall pole with black wires dangling across the road from their small home. Pointing to the cables, Isaiah Vance said he couldn’t get phone service anymore.
Verizon announced plans last year to buy Frontier for an estimated $20 billion. The deal, which must be approved by federal and state regulators, is expected to be completed in early 2026, according to an investor’s press release.
In its federal merger application, Frontier stated that it had taken on too much debt after emerging from bankruptcy and that debt would make it difficult to finish the work of installing fiber to customers in 25 states.
In West Virginia, Frontier’s Allison Ellis wrote in March 3 testimony, seeking approval for the merger from state regulators, that Verizon will honor the rural program commitments. The previous month, in February, Frontier filed a motion with the state public service commission to keep the number of customers using copper lines and the faster fiber-optic lines confidential.
Kelly Workman, West Virginia’s broadband director, said during a November interview that her office has asked federal regulators for “greater visibility” into Frontier’s rural program construction, particularly because those locations cannot win the Biden-era infrastructure money when it’s available.
“The worst-case scenario would be for any of these locations to be left behind,” Workman said.
Frontier’s progress installing fiber-optic lines and its unreliable service have frustrated West Virginians for years. In a 2020 letter to the FCC, U.S. Sen. Shelley Moore Capito (R-W.Va.) cited “the failure of Frontier to deliver on promises to federal partners” and its “mismanagement” of federal dollars, which forced the state to pay back $4.7 million because of improper use and missed deadlines.
Michael Holstine, a longtime member of the West Virginia Broadband Enhancement Council, said the company has “just used West Virginia as a money cow.” Holstine has been fighting for the construction of fiber-optic lines in Pocahontas County for years. “I really just hope I get it before I die.”
Across the state, people like Holstine and Adkins are eager for updated networks, according to interviews as well as letters released under a public records request.
Chrissy Murray, vice president of Frontier’s external communications, acknowledged that the company was “building back our community efforts” in West Virginia after a bankruptcy filing and reorganization. She said there has been a “notable decline” in consumer complaints, though she did not provide specific numbers.
Murray said Frontier built fiber-optic cables to 20% of its designated rural funds locations as of the end of 2024. It has also invested in other infrastructure projects across the state, she said in a January email, adding that the company donated high-speed fiber internet to West Virginia University’s rural Jackson’s Mill campus.
According to data tracked by a federal agency, Frontier has connected 6,100 — or fewer than 10% — of the more than 79,000 locations it was awarded in the Rural Digital Opportunity Fund program.
The FCC oversees the rural fund. The agency did not respond to a request for comment. Frontier expects to receive $37 million annually from the agency through 2032, according to a federal filing.
In April, a new batch of letters from West Virginia residents filed as “support” for Frontier’s merger with Verizon appeared in the state regulatory docket:
“My support for this case depends on whether Verizon plans to upgrade or replace the existing Frontier infrastructure,” wrote one customer in Summers County, in the far southern corner of the state, adding, “West Virginians in my neck of the woods have been held hostage by Frontier for a generation now because no other providers exist.”
A customer from Hardy County, in the state’s northeastern corner, wrote: “This is [a] move by frontier to to [sic] escape its responsibility to continue services.”
Adkins moved to Upper Mud River with her husband, Bobby, decades ago.
For years, Bobby and Ada Carol Adkins ran a “carry-out” on Upper Mud River Road. The old building is still at the rock quarry just down the hill and around the curve from where her trailer sits.
It was the type of store where locals kept a tab — which Bobby treated too much like a “charity,” Adkins said. They sold cigarettes, beer, bread, bags of chips, and some food items like potatoes and rice. “Whatever the community would want,” she said.
Then, Bobby Adkins’ “health started deteriorating and money got tighter,” Adkins said. He died at 62 years old.
Now, Adkins said, “I’m having kidney problems. I got arthritis, they’re treating me for high blood pressure.”
Her doctor has begun sending notes over the internet to refill her blood pressure medicine and, Adkins said, “I love that!”
But Adkins’ internet was out again in early April, and she can’t afford Starlink like her neighbors. Even as Adkins said she is “deep-rooted,” her son’s request is on her mind.
“I’m having health problems,” Adkins said. “He makes a lot of sense.”
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