Copyright Norfolk Virginian-Pilot
Virginians who get health insurance through the Affordable Care Act marketplace are facing sharp increases in monthly premiums as open enrollment kicks off Nov. 1. The federal government has been shut down for 31 days, and without a deal to extend tax credits to help people afford insurance coverage, customers could see increases of as high as 370% in some areas. A 60-year-old couple with the gold plan at 300% of the federal poverty line ($63,450) will see their monthly premium increase by 83%, from $250.90 to $459.90, which is roughly in line with increases expected for Henrico, Fairfax and Roanoke counties, according to the Virginia State Corporation Commission. A family of four with two children at 300% of the federal poverty line ($96,450) will see their premiums increase by $318, or about 80%. A 45-year-old at 200% of the federal poverty line ($31,300) with no dependents will see an increase of $120, or about 345%, according to the Virginia SCC. The highest increase in the SCC’s example data will be seen by a 45-year-old with no dependents and an income of $31,300 – a $372% increase from $32.22 to $152.22. As a result, as many as 100,000 residents are expected to drop their coverage, according to the Virginia SCC. About 390,000 Virginians received health insurance through the marketplace in 2025. “About half of those folks are going to find insurance elsewhere but it might not be as good, it might be more expensive, and the other half are just going to go without insurance entirely,” said Katie Baker, director of Protect Our Care, a nonprofit that operates in 10 states including Virginia that advocates for more affordable health care, during a news conference hosted Friday by Democratic U.S. Sen. Mark Warner. In August, the state SCC said that the 10 insurers planning to participate in Virginia’s individual market in 2026 were asking for average increases of 20% or higher, citing market changes brought about by the elimination of enhanced subsidies, market uncertainty and hospital and pharmacy costs. “Even if you don’t qualify or don’t take the tax credits, your plans are still going up by that 20% because when you’ve got that smaller and sicker pool it drives up costs for everybody,” Baker said. Warner urged elected leaders to reach a deal to reopen the government. “I can’t think of anything more potentially devastating than the fact that if somebody has to make the choice of not getting healthcare at the very same time that food assistance is going away, this shouldn’t be the kind of circumstance that any family should go through,” the senator said. Gavin Stone, 757-712-4806, gavin.stone@virginiamedia.com
