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2026 Session

Budget Amendments - HB30 (Committee Approved)

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State Premium Assistance Program

Item 478 #2h

Item 478 #2h

First Year - FY2027 Second Year - FY2028
Independent Agencies
State Corporation Commission FY2027 $79,100,000 FY2028 $0 GF

Language
Page 550, line 2, strike "$558,582,934" and insert "$637,682,934".

Page 550, after line 33, insert:

"F. There is hereby appropriated to the State Corporation Commission the sum of $79,100,000 the first year from the general fund to create a non-reverting special fund known as the Virginia Health Insurance Affordability Fund. The Health Benefit Exchange (Exchange) shall develop and operate a program for plan year 2027 to reduce the monthly health insurance premiums for Virginia consumers of Qualified Health Plans sold through the Virginia state-based marketplace operated by the Exchange. Amounts in the Fund shall only be used for premium reduction payments under this program. The Exchange shall develop eligibility rules for the  program that reduces the average monthly net premium by as much as 70 percent for individuals and families with household incomes greater than or equal to 138 percent of the federal poverty level and less than 200 percent of the federal poverty level. The Exchange is authorized to adjust the monthly premium reduction payment amount up or down as enrollment and fund balances change to maximize the use of the Fund consistent with the objective of this program. The Exchange shall develop other rules and parameters reasonably necessary to implement and operate this program. Any unexpended balances for the purposes specified in this paragraph which are unexpended on June 30, 2027, shall not revert to the general fund but shall be carried forward and reappropriated in fiscal year 2028."



Explanation

(This amendment adds $79.1 million from the general fund the first year for a state-based premium assistance program for plan year 2027, targeted to individuals who purchase health insurance from Qualified Health Plans sold through the Virginia state-based marketplace with incomes between 138 percent and 200 percent of the federal poverty income level. Funding will be used to lower the average monthly net premium by as much as 70 percent. Language provides flexibility for the Health Benefit Exchange to adjust the monthly premium reduction payment up or down as enrollment and fund balances change to maximize the use of the funding. Language allows the agency to carry funds over into fiscal year 2028 since the premium assistance will be provided in calendar year 2027. It is estimated that the program will serve approximately 117,000 Virginians.)