Health insurance in Virginia
- Virginia uses the federally run exchange so applicants enroll through HealthCare.gov.
- Eight insurers are offering 2019 coverage in the state’s individual market.
- Open enrollment for 2019 coverage in Virginia ended on December 15.
- Enrollment is still open for Virginians with qualifying events.
- Short-term health plans are available in Virginia with initial plan terms up to 364 days.
- The average premium increases for 2019 were 9.6 percent.
- 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.)
Open enrollment for 2019 coverage ended on December 15, but residents with qualifying events may still be eligible for a special enrollment period.
Eight insurers will offer 2019 coverage through the state’s exchange. (Seven insurers have remained on the exchange while Virginia Premier has also joined the exchange.)
Virginia enrollment in qualified health plans
HHS estimated that 470,998 Virginians were eligible for exchange plans in 2015 and that 355,017 of them were eligible for premium subsidies. By the end of 2015 open enrollment, 385,154 people had finalized their enrollment in qualified health plans through Virginia’s exchange, the sixth highest total enrollment among the 34 states where HHS is running the exchange.
During the 2016 open enrollment period, the number of Virginia enrollees grew 9.5 percent over 2015 and reached 421,897. Of these enrollees, 37 percent were new to the exchange. By March 2016, effectuated enrollment was 378,838, and 84.2 percent of those individuals were receiving subsidies that averaged $276 per month.
During the first five years of exchange operation, 2016 had the highest enrollment. 410,726 people enrolled for 2017, and enrollment fell again, 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.
Read more about Virginia’s health insurance exchange.
Medicaid expansion in Virginia
Virginia lawmakers passed a budget in 2018 that calls for Medicaid expansion, and Gov. Northam signed it into law in June 2018. Roughly 400,000 Virginia residents will become eligible for Medicaid as of January 2019. The federal government will always pay the majority of the cost of covering the newly-eligible population, but Virginia will eventually have to pay 10 percent of the cost.
Northam and his predecessor had pushed for Medicaid expansion since 2014, but the Republican-led legislature in Richmond has consistently rejected expansion.
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.
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. The uninsured rate has not dropped as much as it would have if Medicaid had been expanded in Virginia, but it had still fallen to 8.7 percent by 2016.
Although Medicaid has not been expanded, total enrollment in Virginia Medicaid and CHIP has grown by 8 percent since 2013, due in part to the outreach and enrollment assistance from the exchange—people who were already eligible for Medicaid have found out about their eligibility and received assistance with the enrollment process.
As of 2017, there were more than 300,000 people receiving premium subsidies in the Virginia exchange. The subsidies averaged $317.26/month, making coverage affordable for people who would otherwise not be able to afford it.
The premium subsidies were much larger in 2018, because premiums increased so much. The benchmark plan on which subsidies are based is a Silver plan, and Silver plan rates rose considerably in Virginia for 2018. But because the ACA’s premium subsidies increase to keep pace with the benchmark premium, hundreds of thousands of Virginia residents still had access to affordable individual market coverage, despite the rate increases.
Medicare in the state of Virginia
In 2015, Virginia Medicare enrollment trended slightly lower than the total U.S. population enrolled in Medicare – 16 percent of its total population, compared with 17 percent nationwide. The state spends about $8,127 per enrollee, annually, also just below the national average of $8,970 per enrollee. As of 2009, the state ranks 14th in the nation in terms of total spending.
Virginians who qualify for Medicare can purchase a Medicare Advantage plan instead of traditional Medicare. These private plans offer additional benefits, and 17 percent of Virginia Medicare recipients selected a Medicare Advantage plan in 2017. About 46 percent of Virginia enrollees chose Medicare Part D prescription drug coverage.
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.