Virginia Health Insurance 2026

Virginia launched its own state-based exchange, Virginia's Insurance Marketplace (formerly managed through Healthcare.gov), in 2023, gaining more control over enrollment and outreach. The marketplace offers 70–110 plans, with Kaiser Permanente, Anthem, and Cigna as the leading carriers. Silver premiums average $425–$445/month for a 40-year-old before subsidies. The Northern Virginia/DC suburbs and Richmond metros have the most competitive markets and robust networks; Southwest Virginia's rural Appalachian communities have more limited options. Virginia extended its open enrollment period through January 31.

Virginia expanded Medicaid in January 2019 after Democrats gained control of the state legislature, ending years of Republican-led resistance. The expansion (Cardinal Care) has covered approximately 600,000 Virginians. Virginia has also implemented innovative managed care models for behavioral health and long-term care within Medicaid. The state's proximity to the federal government provides a large pool of federal employees covered through FEHB programs, which shapes insurer network designs. Virginia has pursued reinsurance waiver studies and continues to expand enrollment infrastructure.