Enrollment in the Affordable Care Act (ACA) in Virginia has reportedly decreased following the recent expiration of the “expanded premium tax credit.” With approximately 370,000 subscribers recorded on the Virginia ACA Health Insurance Marketplace, about 33,000 of them have discontinued their insurance. A simple calculation suggests a decrease of about 9% in total subscribers.
Keven Patchett, Director of the State Health Exchange, stated at a recent State Corporation Commission forum, “About 33,000 people have discontinued their ACA insurance since the subsidy expired.” This represents the largest decline recorded in the first quarter of this year, and it is analyzed that some have withdrawn because they could no longer afford the premiums or have switched to plans with lower coverage levels.
The expiration of the “Expanded Premium Tax Credit,” which was temporarily expanded during the pandemic, is cited as a major factor behind the recent decline in subscribers. This program broadened the scope of existing ACA subsidies to lower insurance premium burdens for income earners exceeding 400% of the Federal Poverty Level (FPL). However, with the termination of the expanded subsidy, those with incomes above 400% of the FPL no longer receive any subsidies. Consequently, some subscribers are showing a tendency to either be unable to maintain their insurance or to choose lower-cost alternatives.
Sim Yeon-sik, an Obamacare insurance agent, explained, “In the case of Virginia, the number of Obamacare subscribers decreased compared to the previous year.” He added, “The biggest reason is that due to the expiration of the Expanded Premium Tax Credit, premiums for those above 400% of the FPL—based on a two-person household—more than doubled; those who previously paid around $600 in premiums now pay over $1,200.” In contrast, neighboring Maryland saw a slight increase, rising from approximately 247,240 subscribers in 2025 to approximately 255,610 in 2026.
It is assessed that the increase in enrollment and retention was achieved due to factors such as the introduction of state-level subsidy programs. Agent Sim stated, “In the case of Maryland, the state government provided separate subsidies even after the extended subsidy ended, so the fluctuation in ACA enrollment actually increased slightly.”
Nationwide, ACA enrollment also showed a downward trend following the discontinuation of extended subsidies and premium increases. The number of ACA subscribers is projected to reach 24.2 million by 2025, while the number of subscribers this year stands at 23 million, representing a decrease of approximately 1.2 million (5%).