Chapter 65 of Title 38.2 of the Code of Virginia established the Virginia Health Benefit Exchange Division (the Exchange) within the State Corporation Commission (the Commission). The Exchange is responsible for the administration of Virginia’s Insurance Marketplace. The purpose of the Marketplace is to facilitate the sale and purchase of Qualified Health Plans and standalone Qualified Dental Plans, to support the continuity of health coverage, and to reduce the number of uninsured Virginians.

The second Open Enrollment period for Virginia’s Insurance Marketplace occurred from November 1, 2024-January 22, 2025. During this period the number of new enrollments increased by 21%, while overall enrollment decreased marginally, by 2.9%.

This year, several major federal policy developments have impacted the Exchange’s preparation for plan year 2026 open enrollment. These include the Center for Medicare and Medicaid Services 2025 Marketplace Integrity and Affordability Rule, House Resolution 1, “One Big Beautiful Bill Act", and the pending expiration of federal enhanced premium tax credits on December 31, 2025. The Exchange has worked to implement operational and policy changes to comport with federal requirements and to prepare consumers and stakeholders for the upcoming eligibility and enrollment changes. If Congress does not extend the enhanced premium tax credits for plan year 2026, the Exchange expects to see substantial enrollment losses in Virginia and across the nation in the upcoming year.

As required by § 38.2-6516, the Exchange, in collaboration with the Secretary of Health and Human Resources, submits this report annually to the Chairs of the Senate Committees on Commerce and Labor and Finance and Appropriations and the House Committees on Labor and Commerce and Appropriations. It addresses:

1. Exchange operations and responsibilities,

2. An accounting of the Exchange’s finances,

3. The effectiveness of the outreach and implementation activities of the Exchange in reducing the number of individuals without health insurance coverage; and

4. Other relevant information.