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July 22, 2015

Now That The Dust Has Settled

Last month the Supreme Court saved the health care of nearly 286,000 Virginians by upholding the tax credits that help make health insurance affordable in the state’s federal marketplace. While this decision is a victory for those signed up for coverage, many Virginians who are eligible have yet to take advantage of the tax credits in the marketplace. It’s time to renew enrollment efforts to sign people up for the health coverage they need and deserve.

Only 55 percent of Virginians who qualify for tax credits to help them purchase health insurance through the marketplace have signed up, according to the Kaiser Family Foundation. While that gives Virginia the 14th highest enrollment numbers in the nation, it also means that nearly 235,000 people are still missing out on affordable, high-quality health care. Getting these folks enrolled could mean more money in their pockets and reduced pressure on their families as they struggle to make ends meet.


Virginia has made successful enrollment pushes before. In 2014, the state created A Healthy Virginia, a plan which, among other things, secured $13.6 million in federal funding for hiring outreach staff, launching an educational and media campaign about the marketplace, and coordinating efforts with nonprofits like Enroll Virginia. These efforts paid off when an additional 168,000 people signed up for coverage in 2015.

But, at best, that funding will only get us through the next open enrollment period – which runs from November 1st through January 31st – when people can register for coverage that starts in 2016. That’s because the funding was intended to help people learn about the marketplace when it was still new, and those days are almost over.

So with the start of open enrollment fast approaching, Virginia needs to renew its outreach efforts to get more of these 235,000 people signed up for health insurance. One way the state could enroll these folks is by targeting efforts to the areas that have the highest concentrations of eligible people. To that end, the Kaiser Family Foundation has a new tool that identifies which regions in the state have the largest potential for additional enrollment. For example, the New River Valley and Central Shenandoah regions have substantial opportunity to enroll more people based on the low percentage of eligible residents currently enrolled.

However, even if more eligible Virginians got coverage through the marketplace, 195,000 people will still be without coverage. That’s because they’re stuck in the coverage gap, where they don’t make enough money to qualify for the tax credits in the marketplace but make too much to qualify for Virginia’s meager Medicaid program.

Making too much to qualify for Medicaid actually means making very little. For example, if a family of three in the Shenandoah Valley’s Rockingham County makes more than $7,800 a year, that’s too much. That’s right – parents in a family of three can’t get covered right now if they collectively make more than $650 per month. And adults without kids can’t get covered at all unless they are aged, blind, disabled, or pregnant.

This problem exists because of the General Assembly’s stubborn refusal to take the commonsense step of accepting billions of federal dollars to close the coverage gap. Lawmakers continue to block this funding despite the fact that this new coverage would free up hundreds of millions of dollars the state currently spends on health care and would  bring health, financial, and economic benefits to a large swath of Virginians.

So now that the Affordable Care Act has been affirmed – again – as the law of the land, let’s renew our efforts to enroll more Virginians and close the coverage gap. It’s not just the right thing to do, it’s a win-win for the state and for Virginians.

–Gabriel Morey, Policy Intern

The Commonwealth Institute

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