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October 27, 2015

Sunday, Sunday, Sunday!

Hundreds of thousands of Virginians were able to afford private health insurance over the last two years through, a tool created by the Affordable Care Act. Starting Sunday, thousands more will have the opportunity to sign up for health insurance for 2016 during the marketplace open enrollment period which lasts from November 1 to January 31.

Health insurance is an important tool for making sure people can get the medical care they need. It leads to healthier people and lower costs. It protects families from the financial ruin a debilitating illness can cause. In Virginia, 385,000 people enrolled in health insurance using the marketplace in 2015 – a 77 percent increase over 2014. Of those, 319,000 received subsidies in the form of tax credits which were an important boost in making their coverage affordable.

The benefits are tangible. People with health insurance are more likely to get recommended preventive care like mammograms, which limits preventable deaths. It helps control costs by increasing regular doctor visits and reducing expensive trips to emergency rooms.

Protection from financial ruin is important because 47 percent of Americans estimate they can’t pay for an unexpected $400 expense through savings without borrowing money or selling possessions. In fact, about half of Americans without health insurance have less than $100 in savings. Recipients of insurance in The Oregon Health Insurance Experiment were 50 percent less likely to borrow money or fail to pay bills because of medical debt and 80 percent less likely to have catastrophic medical expenses.

Many in Virginia have yet to seize these benefits. In 2015, 235,000 residents – 29 percent of Virginians without health insurance – were eligible for tax subsidies in the marketplace. Misperceptions about cost, lack of awareness about financial assistance, and confusion about eligibility rules were the biggest causes.


But there are reasons to think enrollment will continue to grow in 2016 and beyond. First, the June U.S. Supreme Court decision King v. Burwell upheld the premium tax credits used in states, like Virginia, that decided to let the federal government run their exchanges. With that settled, hold-outs scared of uncertainty should sign on. Second, the fines for not having minimum essential coverage without an exemption are set to increase to $695 (or 2.5 percent of taxable income, whichever is greater) in 2016, from $325 or 2 percent of taxable income in 2015.

Finally, landmark achievements often take time to take hold. Medicaid (1965) and the Children’s Health Insurance Program (1997) were not universally adopted in their early years. Today they are bedrock protections for families struggling to make ends meet. Increasing awareness and an increased emphasis on education and outreach like Governor McAuliffe’s Healthy Virginia plan should continue to boost enrollment in 2016.

A healthy population is an essential part of strengthening Virginia’s economy and promoting broad prosperity. The marketplace created by the Affordable Care Act is a crucial tool for increasing health insurance coverage and health care access for Virginians. Starting Sunday, thousands more will be able to take a huge step in experiencing the power of these benefits firsthand.

–Aaron Williams, Research Assistant

The Commonwealth Institute

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