In 1995, the Virginia Medical Savings Account Act (Act) enacted by the GeneralAssembly became law, with the Virginia Medical Savings Account Plan to be established by the Bureau of Insurance (Bureau) and other designated agencies upon congressional authorization of plan components “for the purpose of providing the Commonwealth's people with a future that includes affordable health care." The initial plan was prepared pursuant to the Act, repealed in 2005, and reconstituted in § 38.2-5601 of the Code of Virginia as the Virginia Health Savings Account Plan (Plan).

Consistent with federal law, the Plan was to identify measures to increase the use and efficacy of health savings accounts within the Commonwealth of Virginia and include recommendations for legislation to increase the attractiveness of health savings accounts or eliminate barriers to their use.

Since 2005, the State Corporation Commission (Commission) and, until 2016 the Department of Taxation, have been charged with updating the Plan, annually. For the Commission, this is accomplished by:

• including a report on the availability of high deductible health plans; and

• identifying measures to increase the utilization and efficacy of health savings accounts, including recommendations for legislation to increase their attractiveness or eliminate barriers to their use.

On behalf of the Commission, the Bureau of Insurance submits this report, with the following findings for this reporting period:

• High deductible health plans were widely available in Virginia at year-end 2022, with 23 companies offering them for use with health savings accounts, which is an increase of two companies since year-end 2021; and

• The Bureau did not identify any statutory or regulatory barriers to the sale of high deductible health plans that would restrict their attractiveness to Virginians. As a result, it recommends no legislative changes to the Plan in this regard.