By Louise Norris
March 31, 2014
Open enrollment in Virginia ends on March 31. But HHS is allowing an extension for applicants who begin the process by that date, but are unable to complete their enrollment by the end of the day on March 31. The extension is expected to be valid until mid-April, and applicants will have to attest to the fact that they tried to enroll by March 31 but were unable to finish because of technical problems or other extenuating circumstances.
102,815 people had selected a private plan in the Virginia exchange by March 1 – the second month in a row with an increase of nearly 30,000 people per month. An additional 33,897 people had been found to be eligible for Medicaid or CHIP during the first four months of open enrollment. And officials believe that there may be 40,000 other Medicaid applications that are stuck in limbo in the HHS-run exchange. Virginia has not expanded Medicaid, but is working out the details of the “Virginia way” that political leaders are offering as an alternative to Medicaid expansion. It’s still unknown whether their proposal will receive HHS approval.
In good news for the exchange, on February 18 a Federal Judge in Virginia rejected the arguments of three Virginia plaintiffs in a lawsuit claiming that subsidies were only to be available in states running their own exchanges. This latest decision comes on the heels of similar rulings on other lawsuits that made the same challenge to the ACA.
Although the federally facilitated marketplace (FFM) in Virginia is doing well, lawmakers in the state are also considering the creation of a private marketplace (Marketplace Virginia). As of early February, the proposal, described as a “commercial alternative to the federal and state marketplaces created under the ACA,”was under review by Senate committees. While not technically Medicaid expansion, lawmakers explain that Marketplace Virginia would use federal funds to help provide private coverage for people who would otherwise be covered by Medicaid if the state did expand the program.
Virginia’s exchange is run by HHS, with nine insurers offering a total of 105 different plans. The competition among carriers means that rates are lower than the national average: Across all ages, the average lowest cost bronze plan is $237/month, compared with $249 nationally. Plans in the exchange are sold by Optima Health, Anthem Blue Cross and Blue Shield, CoventryOne, CareFirst BlueChoice, Inc. Innovation Health Insurance Company, CareFirst BlueCross BlueShield, Kaiser Permanente, Aetna and Anthem Health Plans of Virginia.
Virginia Gov. Bob McDonnell, a Republican, opposed the Affordable Care Act. But along with the Republican-controlled General Assembly, he was conflicted as how best to resist the law’s implementation in the state. In a 2011 letter to state legislative leaders, McDonnell wrote of extreme difficulty in determining whether “ceding control of an exchange to the federal government or creating our own is in the Commonwealth’s best interest.” The governor’s and General Assembly’s actions over the next few years reflected their shared reluctance to implement either option.
In August 2010, McDonnell appointed the Health Reform Initiative Advisory Council. The council issued a report in December 2010 and recommended that Virginia implement a state-based exchange.
The Virginia General Assembly passed legislation in 2010 to invalidate the individual mandate of the Affordable Care Act, and the state attorney general filed a lawsuit against Kathleen Sebelius, the secretary of the U.S. Department of Health and Human Services, based on the new law. After a series of legal actions, the state law was ultimately ruled invalid.
In 2011, the General Assembly passed legislation that was supportive of a state-based exchange, and McDonnell signed the bill into law. However, throughout the 2012 session the General Assembly failed to pass additional legislation necessary to move ahead with exchange implementation.
Finally, after President Obama’s re-election, McDonnell notified HHS that Virginia would not proceed with a state-based exchange nor Medicaid expansion. While the norm for the federally operated exchange leaves no role for the state, McDonnell did lobby for oversight of the health plans that will operate on the exchange within the state. HHS approved McDonnell’s request in March 2013, and the federally-run exchange opened for business on October 1 with health plans overseen by the state Division of Insurance.
According to Kaiser’s State Health Facts, 14 percent of Virginians do not have health insurance.
Virginia Consumer Assistance Program
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(877) 310-6560 / firstname.lastname@example.org
State Exchange Profile: Virginia
The Henry J. Kaiser Family Foundation overview of Virginia’s progress toward creating a state health insurance exchange.
Let your Virginia governor and legislators know how you feel about the state’s proposed health insurance exchange.Virginia Governor Bob McDonnell