This story was reported and written by VPM News.
Open enrollment begins for Virginia's health insurance marketplace on Saturday, but the annual process is marked with uncertainty this year due to rising costs and expiring federal subsidies.
Roughly 360,000 people began getting notifications last week from the State Corporation Commission — which runs the Virginia Health Benefit Exchange — informing them that they are eligible for insurance coverage in 2026. The recipients were told they would be automatically enrolled into an insurance plan, the cost of that plan, and their eligibility for premium tax credits, which help lower the cost of insurance.
Open enrollment runs from Nov. 1 through Jan. 30, 2026, so customers have three months to shop around for different plans that better meet their needs, or allow their coverage to auto-renew.
Keven Patchett, director of the Virginia Health Benefit Exchange, told VPM News that despite the uncertainty, now is the best time for people who do not get insurance through their employers to enroll for coverage: "We are here at the marketplace to provide stability, to provide resources to Virginia customers who are shopping for or want to make changes to their health insurance."
This year, customers will have to consider several factors that are causing their health insurance rates to go up — with some plans set to cost customers up to five times the amount they paid last year.
Virginia's insurance rates are set to rise an average of 20% as part of an annual increase that's set by insurance companies and then approved by Virginia's Bureau of Insurance — another division of SCC. Those increases take into account market uncertainty, the growing costs associated with providing health care and insurance carriers' assessments of their risk pools.
But the greater cause for cost increases, according to Patchett, can be attributed to the expected expiration of enhanced federal premium tax credits, an issue that sits at the center of the ongoing federal government shutdown.
Congress created the enhanced credits under the American Rescue Plan Act in 2021 to temporarily expand eligibility for more affordable health insurance options. They are set to expire at the end of 2025, despite efforts from Democrats and some Republicans — including Rep. Jen Kiggans (R–Va.) — to either temporarily or permanently extend them.
"The expiration of those premium tax credits is really where Virginia consumers are going to feel the biggest difference in what they pay each month for their health insurance," Patchett told VPM News.
Patchett said the Virginia Health Exchange has contingency plans in place in case Congress takes action to extend the enhanced tax credits during open enrollment. Those plans involve informing customers that the cost of the insurance plan they signed up for may decrease, and then re-renew all of the 360,000 customers who use the exchange.
"If there is an extension, what people in Virginia are paying will only get better and not worse," Patchett said. "We will do that work as quickly as we can to make sure that Virginians are getting everything they're eligible for."
The SCC supports three grant-funded organizations that help people navigate selecting the best insurance plan for themselves or their family. Enroll Virginia, Boat People SOS and Health Betterment Initiative provide nearly 6,000 certified assistants to guide people through the enrollment process.
Deepak Madala, director of Enroll Virginia, said the organization is working with families who are weighing how much they can afford: "A lot of people are having to make hard decisions."
Madala told VPM News some families have been faced with the choice of splitting between multiple coverage plans — with members who are likely to need more health care selecting a plan with more coverage, but higher premiums, while other family members trade lower up-front costs for higher deductibles.
He said it's not only premiums that have gotten more expensive: "Over the last four or five years, deductibles have gone up quite a bit."
He said on plans with lower premiums, the deductible — the amount a policyholder is expected to pay out of pocket each year before the insurance company starts covering some or all of the cost of covered care — could run up to $20,000.
"It's kind of having to dig in a little bit more to the plans and work with people to get the best value they can out of those plans," Madala said.
But he told VPM News that researching plans is worth the work. Roughly 85% of eligible customers allow their plans to auto-renew, but Madala said that could end up being a costly choice.
"Especially this year, it's really important that people do not do that," Madala said. He recommended that people "go into their account, and see what the plan looks like, what the prices look like, to see if there's other options."
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