In 1995, the Virginia Medical Savings Account Act (Act) became law, directing the Bureau of Insurance (Bureau) and other designated agencies to establish the Virginia Medical Savings Account Plan upon congressional authorization of plan components “[f]or the purpose of providing the Commonwealth’s people with a future that includes affordable health care."(*1) The initial plan was prepared pursuant to the Act, repealed in 2005, and reconstituted in § 38.2-5601 of the Code of Virginia (Code) as the Virginia Health Savings Account Plan (Plan).

Consistent with federal law, the Plan identifies measures to increase the use and efficacy of health savings accounts (HSA) within the Commonwealth and includes recommendations for legislation to increase the attractiveness of HSAs 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 (HDHP); and

• Identifying measures to increase the utilization and efficacy of health savings accounts, (*2) including recommendations for legislation to increase their attractiveness or eliminate barriers to their use.(*3)

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

• HDHPs were widely available in Virginia at year-end 2024, with 23 companies offering them for use with HSAs – the same 23 offering them at year-end 2023. However, nine companies reported offering no HDHPs during the 2025 calendar year, compared to just one company in the 2024 calendar year.

• The Bureau did not identify any statutory or regulatory barriers to the sale of HSAs and HDHPs that restrict their attractiveness to Virginians. As a result, it recommends no legislative changes to the Plan.
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(*1) § 1, Virginia Medical Savings Account Act, Chapter 650, 1995 Acts of the Assembly.
(*2) Pursuant to IRS Publication 969 (2024), “to be an eligible individual and qualify for an HSA contribution … you must … (be) covered under a high deductible health plan."
(*3) Pursuant to subsection B of § 38.2-5601 of the Code, one way would be by providing “(m)easures that would encourage public and private employers to offer, as part of a cafeteria menu of insurance plans, high-deductible health plans that would qualify for a health savings account pursuant to § 223 of the Internal Revenue Code of 1986, as amended.