In response to Chapter 480 of the 2021 Virginia Acts of Assembly, the Bureau of Insurance (Bureau) applied for and received federal approval to establish the Commonwealth Health Reinsurance Program (CHRP) in the individual health insurance market for up to five years. Virginia’s program is designed to make individual health insurance coverage more affordable, particularly for unsubsidized individuals, encouraging a more stable membership base that will support increased competition among issuers and, as a result, expand consumer choice.

Pursuant to Enactment Clause 4, the act requires the State Corporation Commission, within 120 days after the second full year of program operation, to complete a study evaluating program effects on:

1. access to affordable, high-value health insurance for enrollees eligible for premium tax credit subsidies and cost-sharing reductions, and

2. health plan affordability, including cost-sharing and premiums.

The CHRP has been in place since benefit year 2023. While it is only one of many policies that impact individual health insurance coverage, marketplace(*1) enrollment, and health care costs, the program has nonetheless contributed to increased health insurance access and plan affordability by reimbursing carriers for a portion of their high-cost claims and increasing enrollment. This report studies the resulting changes in enrollment, premiums, cost-sharing, and plan selection during the first two years of program operation that supports this conclusion.

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(*1) As used in this report, “marketplace" refers to the federally facilitated exchange or marketplace or, beginning in 2024, Virginia’s state-based health benefit exchange or insurance marketplace, under which Virginians purchase individual health insurance coverage.