Virginia Insurance Marketplace announces details of new state-based subsidy program

Back in July, the Virginia ACA exchange (the rather unimaginatively named "Virginia's Insurance Marketplace") announced that they were planning on becoming the latest state to offer their own supplemental insurance premium subsidies for ACA enrollees:

About 200,000 Virginians will be eligible to tap into new state funding meant to offset costs for insurance through the state’s Affordable Care Act exchange, starting in November.

This means that participants could save about 70% on their monthly premium, after state lawmakers and Gov. Abigail Spanberger approved $150 million dollars for it in the state budget late last month.

The move comes after federal funding shifts triggered by Congress’ failure to renew expiring ACA subsidies. Thousands of Virginians have dropped their coverage so far this year as premiums have shot up.

Virginia’s Health Benefit Exchange estimates that about 100,000 Virginians have lost their health coverage this year as a result of higher premiums, according to a new press release.

“Most Virginians losing Marketplace coverage this year do not have any other options for health insurance coverage,” exchange director Keven Patchett said. “The new affordability program will go a long way toward helping to ease the cost burden, allowing more Virginia families to enroll in and maintain high-quality health coverage.”

The program targets Virginia households with incomes between 138% and 250% of the federal poverty level, which represents about 45% of people in the state who have lost their coverage this year, according to state data.

A few weeks ago, the VA Marketplace posted more detailed information on how the new state subsidies will work. Remember, these would be in addition to the remaining federal subsidies, which are still available for most enrollees who earn between 138 - 400% FPL:

What is Virginia Premium Savings?

Virginia Premium Savings is a new state-funded program that helps eligible Virginians lower their monthly health insurance premiums. It’s applied on top of any federal premium tax credits you may already qualify for. Your exact savings depend on your income, household size, and the plan you choose. 

New savings don’t apply automatically. You’ll need to enroll to receive them. For most Virginians, open enrollment (November 1, 2026 – January 29, 2027) is the only chance to get the savings on a plan this year, so don’t wait. 

You may be eligible for Virginia Premium Savings if: 

• You live in Virginia 
• You enroll in a health plan through Virginia’s Insurance Marketplace 
• Your household income is between 138% and 250% of the federal poverty level
  • 250% FPL will be up to $39,900 for 1 person & up to $82,500 for 4 people

Eligibility is determined based on your household size and income. In addition, you must:  

• reside in Virginia 
• enroll in a Qualified Health Plan (excluding catastrophic plans) through Virginia's Insurance Marketplace 
• be a U.S. citizen or lawfully present non-citizen who is eligible to enroll in Marketplace coverage 
• not be incarcerated 
• not be enrolled in or eligible for other minimum essential coverage.

Your eligibility for Virginia Premium Savings will be determined when you enroll in 2027 coverage through the Marketplace. If you qualify, the savings will be applied to your monthly premium cost.  

Your monthly savings will be shared with you during the application process. You can compare how your savings reduces each plan’s cost before finalizing your enrollment.  

You can use Virginia Premium Savings to buy comprehensive health coverage through the Marketplace.  The program applies to qualified health plan premiums only. The savings cannot be used on catastrophic plans or stand-alone dental plans.  

Consumers who are eligible to receive Advance Premium Tax Credits must do so to receive Virginia Premium Savings. However, if you are ineligible for APTCs, you may still qualify for Virginia Premium Savings. 

Lawmakers funded the program for Plan Year 2027.

To qualify for Virginia Premium Savings, a consumer must be a U.S. citizen, National or “lawfully present non-Citizen” of the U.S. 

Virginia Premium Savings is not a tax credit and is not reportable on your state tax return.

There's also a recent Richmond Times-Dispatch article with more specifics:

State funds to make up for the loss of enhanced federal Obamacare credits could mean more than 159,000 Virginians will see minimal bills for coverage next year.

...The state subsidy translates to $65 per covered person per month for households earning between 138% and 150% of the federal poverty level, and $90 per person per month for households earning between 150% and 250% of the poverty level, Patchett said.

For a family of four earning no more than $49,500, or 150% of the poverty level, the subsidy amounts to a $260 a month savings on premiums.

The state subsidy amounts to $90 per person per month for modestly better-off households, so for a family of four with an income of $82,500, the subsidy amounts to a monthly saving of $360.

...The enhanced credits were aimed at reducing [net premiums] to between 0% and 4% of income for the households that will be getting the Virginia credit.

...The state exchange found the group hardest hit by the end of the enhanced federal credit were households with income below 150% of the poverty level: 52,500 dropped coverage since the start of enrollment for coverage this year, the first without the enhanced credit or the state subsidy. Another 36,200 with incomes up to 250% of the poverty level also dropped coverage.

But only 7,300 households with incomes about 400% of the poverty level — the group that lost the enhanced credit and that never had the original credit — dropped coverage.