Health Care Coverage Profile:

Virginia
HEALTH COVERAGE AT A GLANCE 1
More Virginians (57.6%) get their insurance from employer sponsored insurance plans, while the national
average for this type of insurance stands at 52.3%.

Additionally, fewer Virginians are covered under Medicaid when compared to the national average; only
8.6% of Virginia residents get their health insurance through Medicaid, while the national average is 14.1%.
Moreover, 12.2% of Virginia residents are Medicare beneficiaries while 4.4% obtain health insurance
coverage through individual plans.

Virginia has a lower uninsured population than other states, with 13.8% of uninsured residents, including
9.3% of Virginia’s children, as compared to the national average of 15.4%.

Health Insurance Coverage of the

Total Population of Virginia Compared to United States

Employer
52.3 4.7 12.4 15.4
United States 14.1 1.2 Individual
Medicaid
Medicare
4.4 12.2 13.8 Other Public
Virginia 57.6 8.6 3.5
Uninsured

0% 20% 40% 60% 80% 100%

CHANGES IN INSURANCE COVERAGE TYPE IN VIRGINIA 2

The percentage of uninsured Virginia residents is on the decline. Between 2007 and 2008, the number of
uninsured Virginians decreased by 2.7%. Virginians covered through the individual market also decreased
(by 0.3%). The table below strongly suggests that Virginia’s employers have been an invaluable safety net to
residents who were otherwise uninsured, as enrollment in employer sponsored insurance plans has
increased by 2.7%.

In addition, Medicaid enrollment increased marginally (0.4%) in Virginia compared to 1.0% in the U.S.
However, despite the small increase, Virginia’s Medicaid expenditures rose by 8.0% between 2004 and 2007
compared to the national expenditure growth of 3.6%.3 This increase may have been due to the increased
cost of health care services, increased utilization, and/or a less healthy population.

Health Care Profile: Virginia Page 1 of 3

National Coalition on Health Care July 2010
 Virginia: Percent Change Among Non-elderly by Coverage Type, 2007-2008 4
Virginia U.S.
Employer Sponsored Insurance 2.7% -1.2%
Individual Market -0.3% -0.2%
Medicaid 0.4% 1.0%
Other Public -0.2% -0.2%
Uninsured -2.7% 0.2%

THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) AND HEALTH INSURANCE COVERAGE5
Individual Mandate
Starting in January of 2014, all individuals will be required to have a certain minimum level of health
insurance. Failure to maintain a minimum level of health insurance will result in a penalty of no greater than
$695 for an individual or $2,085 per family. The individual mandate is expected to decrease the number of
uninsured individuals in Virginia.

Health Insurance Exchanges and Federal Subsidies

Each state will create and administer a health insurance exchange. There will be two separate exchanges,
one for individuals seeking to purchase exchanges on the individual market and another for employers. The
Department of Health and Human Services (HHS) will establish a minimum benefit package that insurance
companies must offer if they wish to be included in the exchange. For Virginians with incomes of 133-400%
above the federal poverty level, the federal government will provide subsidies to make the insurance
affordable.

Employer Coverage
As of 2007, 15.8% of Virginia's working population was uninsured. 6 Generally, small businesses cannot
afford to offer health insurance to their employees; thus, only 44.4% of private businesses with fewer than
50 employees offered health insurance, while 99.0% of private businesses with more than 50 employees
offered health insurance. 7 In order to help small business employees gain access to employer sponsored
insurance coverage, ACA provides a tax credit to qualifying small businesses that offer health insurance.

Additionally, while ACA does not require employers to provide health insurance to employees, employers
with 50 or more employees will be assessed a fee of $2,000 per full-time employee (excluding the first 30
employees from the assessment) if they do not offer coverage and if they have at least one employee who
receives a premium credit through an Exchange.

Medicaid Expansion
Medicaid will be expanded to include all individuals under age 65 with incomes up to 133% of the federal
poverty level. This will establish a minimum eligibility threshold throughout the 50 states and will eliminate
a limitation on the program that prohibits most adults without dependent children from enrolling in
Medicaid. This expansion may make approximately 245,000 previously uninsured Virginians eligible to
enroll in Medicaid.8

Health Care Profile: Virginia Page 2 of 3

National Coalition on Health Care July 2010
1
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic
Supplements), available at http://www.statehealthfacts.org:/comparetable.jsp?ind=125&cat=3 (last accessed June 2010).
2
Unless otherwise cited: THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on
Medicaid and the Uninsured estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual
Social and Economic Supplements), available at http://www.statehealthfacts.org/comparetable.jsp?ind=165&cat=3 (last accessed July
2010).
3
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on data from HCFA/CMS-64 reports, available at http://www.statehealthfacts.org/comparetable.jsp?ind=181&cat=4
(last accessed June 2010).
4
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic
Supplements), available at http://www.statehealthfacts.org/comparetable.jsp?ind=165&cat=3 (last accessed July 2010).
5
Unless otherwise cited: THE KAISER FAMILY FOUNDATION, Summary of New Health Reform Law (2010), available at
http://www.kff.org/healthreform/upload/8061.pdf (last accessed June 2010).
6
COVER THE UNINSURED, ROBERT WOOD JOHNSON FOUNDATION, U.S. UNINSURED WORKERS, available at
http://covertheuninsured.org/uninsured_workers#map (last accessed June 2010). These figures are from 2006-2007.
7
U.S. DEP’T OF HEALTH & HUMAN SVCS. MEDICAL EXPENDITURE PANEL SURVEY (2008), available at
http://www.meps.ahrq.gov/mepsweb/data_stats/summ_tables/insr/state/series_2/2008/tiia1.pdf (last accessed June 2010). These
figures are from 2008.
8
JOHN HOLAHAN & IRENE HEADEN, KAISER COMMISSION ON MEDICAID AND THE UNINSURED, MEDICAID COVERAGE AND SPENDING IN HEALTH REFORM: NATIONAL
AND STATE‐BY‐STATE RESULTS FOR ADULTS AT OR BELOW 133% FPL 41 (2010), available at http://www.kff.org/healthreform/upload/Medicaid-
Coverage-and-Spending-in-Health-Reform-National-and-State-By-State-Results-for-Adults-at-or-Below-133-FPL.pdf (last accessed June
2010).

Health Care Profile: Virginia Page 3 of 3

National Coalition on Health Care July 2010