Health insurance in Virginia
- Virginia uses the federally run exchange so applicants enroll through HealthCare.gov.
- Eight insurers are offering 2020 coverage in the state’s individual market.
- Open enrollment for 2020 health plans has ended, although residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.
- Short-term health plans are available in Virginia with initial plan terms up to 364 days.
- About 400,000 Virginians enrolled in 2018 coverage through the exchange.
- Roughly 400,000 Virginians will become eligible for Medicaid coverage in 2019.
Virginia’s health marketplace
Virginia uses the federally run exchange, so applicants enroll through HealthCare.gov. (Virginia is one of seven federally run exchange states that conducts its own plan management, so the state takes an active role in overseeing plans sold in the exchange.)
But Virginia is actively working towards a transition to a fully state-run marketplace, and could have one by 2023 if legislation currently under consideration ends up being enacted.
Open enrollment for 2020 health plans has ended, although Virginia residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.
Eight insurers are offering 2020 coverage through the state’s exchange, and five of them decreased their average premiums for 2020.
Virginia enrollment in qualified health plans
As was the case in most states that use HealthCare.gov, exchange enrollment peaked in Virginia in 2016, when 421,897 people enrolled. Enrollment dropped to 410,726 people enrolled for 2017, and to 400,015 people for 2018. A similar enrollment decline occurred in most of the other states that use the federally run exchange, due in part to the Trump Administration’s funding cuts for exchange marketing, outreach, and enrollment assistance. In addition, confusion about the status of the ACA’s individual mandate may have played a role.
Virginia expanded Medicaid in 2019, so as expected, enrollment in private plans through Virginia’s exchange dropped substantially for 2020. By the end of open enrollment, 269,474 people signed up for private plans. People with income between 100 and 138 percent of the poverty level used to be eligible for premium subsidies to offset the cost of private plans in Virginia’s exchange. But now that Medicaid has been expanded, these people are eligible for Medicaid instead.
Read more about Virginia’s health insurance exchange.
Medicaid expansion in Virginia
Virginia lawmakers passed a budget in 2018 that called for Medicaid expansion, and Gov. Northam signed it into law in June 2018. Roughly 400,000 Virginia residents became eligible for Medicaid as of January 2019, and enrollment had exceeded 388,000 by February 2020. The federal government will always pay the majority of the cost of covering the newly-eligible population, but Virginia is responsible for paying 10 percent of the cost.
Read more about Medicaid expansion in Virginia.
Short-term health insurance in Virginia
Despite new federal rules regarding short-term health insurance, the duration of short-term health insurance plans in Virginia is limited to six months with no renewals.
Lawmakers in Virginia passed legislation in 2018 aimed at expanding access to short-term plans, but Gov. Ralph Northam vetoed it in an effort to protect consumers and the ACA-compliant risk pool.
And now that Virginia has a Democratic trifecta, lawmakers are considering new bills that would place additional restrictions on short-term plans, including limiting them to three-month terms.
Read more about short-term health insurance in Virginia.
How has Obamacare helped Virginia residents?
Prior to ACA implementation, the uninsured rate in Virginia was 12.3 percent, according to U.S. Census data. It had fallen to 8.7 percent by 2016, and remained at 8.8 percent by 2018 — and has likely fallen quite a bit more since then, as Medicaid expansion took effect in 2019.
Now that Medicaid has been expanded, total enrollment in Medicaid and CHIP in Virginia is 47 percent higher than it was in late 2013, whereas it had only grown by about 8 percent as of 2018 (prior to expansion taking effect).
As of 2019, there were more than 264,000 people receiving premium subsidies in the Virginia exchange. The subsidies averaged nearly $598/month, making coverage affordable for people who would otherwise not be able to afford it.
Medicare in the state of Virginia
As of late 2019, there were 1,522,606 people enrolled in Medicare in Virginia Medicare. That’s about 17.6 percent of the state’s population, which is roughly the same as the percentage of the US population enrolled in Medicare.
Read more about Medicare in Virginia, including details about Medicare Advantage, Medicare Part D, and state rules for Medigap plans.
Virginia health insurance resources
State-based health reform legislation
Scroll to the bottom of the page for information on recent state-level bills related to health reform.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.