$150M program aims to ease Virginia health insurance premiums

Illustration: Maura Losch/Axios
By Sabrina Moreno

Thousands of Virginians may soon see their monthly health insurance bills fall — or even reach $0 — through a new $150 million state savings program that begins accepting enrollment applications on Sunday.

State officials say the rising cost of coverage has already pushed some residents out of the market.

Nearly 100,000 people did not re-enroll in Virginia’s Marketplace this year, according to the governor’s office, while hospitals in the Richmond area are already treating more uninsured patients in their emergency rooms.

At the same time, premiums in Virginia’s Marketplace are projected to increase by an average of 15.8% next year before subsidies, based on HealthInsurance.org’s review of state filings.

The new program, funded by lawmakers to help offset the loss of enhanced federal Affordable Care Act subsidies, is expected to help as many as 200,000 residents afford coverage next year, according to state estimates.

Eligible residents could save an average of $65 to $90 per person each month, the Virginia Health Benefit Exchange said.

More than 50,000 people may qualify for plans with monthly premiums of $0, the governor’s office said.

To qualify, Virginians must earn between 138% and 250% of the federal poverty level, according to the state.

That works out to $22,025 to $39,900 for an individual and $45,540 to $82,500 for a family of four.

Residents can check whether they qualify and compare plans through Virginia’s Insurance Marketplace.

If they are eligible, the savings are automatically applied to their monthly premium, and no separate application is needed.

There is one major limitation: the $150 million will be distributed on a first-come, first-served basis, so there is no guarantee that everyone who qualifies will receive aid.

Residents above the income limits are not eligible, even if higher premiums are creating financial strain.

The funding is currently set to last through 2027, which means future savings remain uncertain.

And even if a plan has a $0 monthly premium, it does not mean health care is free, since deductibles and copays may still apply.

Open enrollment runs through Jan. 29.