Stabilize Individual Health Insurance Market

Item 478 #1s

Language
Page 550, line 2, strike "$558,582,934" and insert "$758,582,934".

Page 550, after line 33, insert:

"F.1. Out of this appropriation, $200,000,000 the first year from the general fund shall be provided to the Virginia Health Benefit Exchange (VHBE) and the State Corporation Commission to establish and administer a state-based premium assistance program to offset the expiration of enhanced federal premium tax credits and maintain affordable coverage for individuals purchasing health insurance through the state's exchange. The program shall provide state-funded premium subsidies for individuals purchasing qualified health plans through the VHBE to cap household premium contributions as a percentage of household income and shall prioritize individuals and families with household incomes below 400 percent of the federal poverty level (FPL). Within the available funding, the VHBE shall design the program to maintain pre-expiration premium affordability levels and to stabilize enrollment. The VHBE is authorized to implement this program for the 2026 plan year through a special enrollment period, if feasible and practical.  Any funding not used for the program in plan year 2026 shall be used to support the program in plan year 2027. The VHBE shall administer the program in a manner that minimizes administrative burden, promotes continuous coverage, and stabilizes the individual health insurance market.

2. On or before December 1 of each year, VHBE shall report to the Governor and the Chairs of the House Appropriations and Senate Finance and Appropriations Committees on program enrollment, premium reductions achieved, and program expenditures.

3. Any unexpended balance on June 30, 2027, shall not revert to the general fund but shall be carried forward and reappropriated in fiscal year 2028."