Health insurance is about to get a lot more expensive: What you can do

Republicans have shut down the federal government because they want to end Affordable Care Act tax credits, and if they get their way, some Virginia families enrolled in the Virginia Insurance Marketplace will pay $500 more per month for health insurance.

Assuming, that is, that they don’t just drop out of having insurance entirely, for the obvious reason of, not being able to afford it.

“If Republicans continue to refuse to act on ACA tax credits, then many Americans will be forced to forgo health insurance next year. This will lead to more people turning to emergency rooms for preventive healthcare, further stress being placed on healthcare providers, and healthcare costs rising even more. Republicans must come to the table now to protect Americans’ healthcare and reopen the government,” U.S. Sens. Tim Kaine and Mark Warner said in a joint statement on Tuesday.

Kaine and Warner have joined fellow Senate Democrats in pushing back at the Republican effort to gut healthcare, as the shutdown initiated by the MAGAs is now in its 28th day.

New data shows that everybody enrolled in the Virginia Insurance Marketplace will get hit, on a sliding scale – if it can be said that one can slide up a hill.

The worst percentage increases will hit hardest at the lowest rungs of the income ladder – under $40,000 for an individual and under $80,000 for a family of four.

Income Range Relative to the Federal Poverty Line	Number of Enrollees	Average Annual Household Income	2026 Average Monthly Gross Premium	2026 Average Monthly Net Premium	Average Monthly Net Premium Increase	Average Net Premium Increase
Between 100 percent and 138 percent or… Between $15,650-$21,597 for an individual Between $32,150-$44,367 for a family of four	52,603	$24,936	$941	$72	+ $35	+ 95 percent
Between 138 percent and 150 percent or… Between $21,597-$23,475 for an individual Between $44,367-$48,225 for a family of four	40,982	$30,149	$1,025	$117	+ $76	+ 185 percent
Between 150 percent and 200 percent or… Between $23,475-$31,300 for an individual Between $48,225-$64,300 for a family of four	69,203	$35,536	$1,055	$192	+ $112	+ 140 percent
Between 200 percent and 250 percent or… Between $31,300-$39,125 for an individual Between $64,300-$80,375 for a family of four	50,729	$49,341	$1,240	$327	+ $164	+ 101 percent
Between 250 percent and 300 percent or… Between $39,125-$46,950 for an individual Between $80,375-$96,450 for a family of four	30,591	$58,600	$1,245	$464	+ $193	+ 71 percent
Between 300 percent and 400 percent or… Between $46,950-$62,600 for an individual Between $96,450-$128,600 for a family of four	30,850	$73,176	$1,275	$631	+ $154	+ 32 percent
Over 400 percent or… Over $62,600 for an individual Over $128,600 for a family of four	27,624	$144,771	$1,388	$1,388	+ $526	+ 61 percent

Open enrollment

---

With open enrollment in the Marketplace set to begin on Saturday, the State Corporation Commission is encouraging Virginians to educate themselves on their options, none of which, really, are good.

“Not all health plans are created alike. Some are not insurance or may not come with the same benefits and protections as ACA-compliant plans,” said Virginia Insurance Commissioner Scott A. White, who is stressing the importance of fully understanding the coverage, costs, provider networks, protections and restrictions before they sign up for any health plan.

“Understand enrollment periods, what ACA-compliant plans must cover and where to turn for legitimate information. If you have questions, the Bureau of Insurance can help,” White said.

The hart part here is, with costs rising exponentially, some may be inclined to try to go with the cheapest options.

The SCC has come up with a checklist that folks can work through before signing up for a health insurance plan.

Ask yourself:

• Does the plan cover the services my family needs or are there limits to the benefits available under the plan?
• Are doctors and medications my family needs covered by the plan?
• What are the monthly premiums and other costs of using health services such as co-pays, coinsurance and deductibles?

Keep the following in mind:

• In Virginia, Virginia’s Insurance Marketplace is the official website to enroll in ACA plans. Enroll by Dec. 31, 2025, for coverage to begin Jan. 1, 2026.
• Although you don’t have to use Virginia’s Insurance Marketplace to enroll in an ACA plan, you must enroll through Virginia’s Insurance Marketplace to receive financial assistance.
• Ask for details of any health plan in writing, including cost and coverage, and make sure you understand what you are purchasing.
• Look for a disclosure indicating whether the health plan complies with the ACA.
• Any policy that excludes coverage for preexisting conditions is not an ACA plan.
• The open enrollment period for buying a 2026 ACA plan (on or off Virginia’s Insurance Marketplace) begins Nov. 1, 2025, and ends Jan. 30, 2026.  Anyone who contacts you to sell individual health insurance plans through an “enrollment period” outside of that is not selling an ACA-compliant policy.
• Do not provide personal information or send money in response to unsolicited calls, emails or texts.
• Verify that an insurance agent, agency or company is licensed in Virginia on the consumer section of the Bureau’s website.
• Be wary of telemarketers from the “national enrollment center,” “national healthcare center,” or other official-sounding name. The Marketplace will not call to sell you health insurance.

For more information, visit the Virginia Bureau of Insurance website or call toll-free at 1-877-310-6560. Use the Health Coverage Plan Comparison Tool to compare plans.

To learn more about Virginia’s Insurance Marketplace, visit Marketplace.Virginia.gov.