At the root of the school employee strike is the growing cost of health care under the WV Public Employees Insurance Agency or PEIA. Over the last several years, the state had underfunded PEIA due to its inability to deal with the state’s long-standing revenue problems that stem from major tax cuts enacted over the last decade. While much attention has focused on the fact that West Virginia ranks 48th in average teacher pay, what is lesser known is the increase in health care costs for school workers over the last several years.