Affordable Care Act subsidies created during the pandemic are set to expire at the end of this year. Thousands of Virginians are bracing for their premiums to double or even triple next year.
For Elizabeth Whittington, a single mom from Chesapeake, the news feels like a breaking point.
Whittington works three jobs, none of which offer employer-sponsored insurance. She first bought coverage on the state’s ACA marketplace years ago, after starting her own business and needing something flexible for her and her young daughter.
Even then, she said, the insurance wasn’t great. The deductibles were approaching $10,000 with high copays and limited benefits. But with the subsidies, it was at least “affordable.”
Now, it isn’t.
Whittington said her monthly premium, which is currently about $105, will triple when the subsidies disappear.
“I think I am part of a large group of individuals who are kind of caught in the middle,” Whittington said. “We ‘make too much’ to qualify for state support, but we're not making enough to really survive.”
Norfolk resident Beth Dryer, who runs a small local nonprofit, is already living the reality that many marketplace enrollees fear. She received a notice of a bill showing her subsidies have already expired, and her monthly premium has jumped to nearly $400 for basic health and dental coverage — more than triple what she used to pay.
“I’m incredibly defeated and worried,” Dryer said. “Everyone gets sick at some point, but I have no idea how I’m supposed to afford care or even access it.”
The looming subsidy expirations threaten to push many Virginians into similar situations, especially those who earn just above the threshold for Medicaid or state assistance.
More than 300,000 Virginians rely on the enhanced marketplace tax credits. Public officials and health economists warn that without them, families with no savings or assets to fall back on will face the hardest choices, including delaying care, taking on debt or going without insurance altogether.
Alex Fella, director of the nonprofit CityWork, analyzed federal enrollment data to identify where Virginians rely most on ACA subsidies.
He found that roughly 41,000 people in Hampton Roads receive premium tax credits, with an average subsidy between $425 to $430 a month. For the region as a whole, that adds up to about $140 million in federal support each year.
But three ZIP codes — 23504 in Norfolk, 23607 in Newport News and 23704 in Portsmouth — stand out as the most vulnerable.
These neighborhoods have some of the lowest household incomes and net worth in the region, meaning many families who live there have less than six months of income in savings or assets.
Fella said that makes them “uniquely unprepared” to absorb an added $400 a month in premiums.“That means less money to spend on groceries, less money to spend on rent, less money to spend on transportation. These issues are compounding in enormous ways for people,” Fella said.
In parts of Virginia Beach, high employment also sits alongside high marketplace enrollment. Fella said that pattern shows many families rely on ACA plans even when they have steady work.
Virginia Marketplace Director Kevin Patchett has urged residents to review their options as open enrollment continues.
He said costs will vary widely by household, and the state is working to provide clearer information and a range of price points.
At the national level, former senior Department of Commerce official Alejandra Castillo said the stakes are equally high because Congress has only weeks left to act.
She said the threat of expiration is “very real,” and the failure to extend subsidies would amount to a significant blow to families earning modest middle-class incomes.
“That's why we need to continue to ensure that everyone is aware of it, and that our legislators and members of Congress will act in a way that will protect the subsidies,” Castillo said.
