Virginia ACA Enrollment Drops 94,000 After Federal Subsidies Expire
Virginia's ACA marketplace enrollment fell from 389,000 in 2025 to 295,000 as of September 2026, a decline attributed largely to expired federal subsidies for individuals between 138% and 250% of the federal poverty level. Virginia lawmakers allocated $150 million in the current state budget to create temporary state-level subsidies that will be available when marketplace enrollment opens in November, potentially saving eligible enrollees about 70% on monthly premiums. The relief is temporary; meanwhile, federal reconciliation legislation will impose Medicaid work requirements affecting over 500,000 Virginia enrollees and reduce immigrant coverage by approximately 5,800 individuals, with hospitals projecting a $31 billion reduction in state Medicaid funding over the next decade.