Health and Family

Health Insurance

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Health Insurance

Without health insurance, citizens often are unable to pay for the medical care they need and frequently forego preventive measures that would make that care unnecessary. Virginia works to reach some uninsured populations through a variety of federal and state programs. However, over 729,000 Virginians under age 65 still lack health insurance.

Why is This Important?

Health insurance generally provides coverage for preventive care, medicine, needed visits to the doctor or emergency room, hospital stays, and other medical expenses. Since certain provisions of the Affordable Care Act (ACA, aka "Obamacare") went into effect, all health insurance policies must provide preventive care free of charge, cover pre-existing conditions without penalty, and place no lifetime caps on the cost of care. Beyond that, policies differ in what additional services they cover, the size of the deductible and/or co-payment, and options for treatment available to the policyholder.

Research has consistently shown that individuals without health insurance have great difficulty accessing the health care system and frequently do not participate in preventive care programs that help deter the development of physical ailments and chronic diseases. When the uninsured do seek treatment, it is often through public hospitals and emergency room care, increasing the financial burden on state and federal coffers.

How is Virginia Doing?

Percent of Residents without Health Care Insurance, by State. See text for explanation.

The uninsured population is measured by the percentage of people under age 65 not covered by private or public health insurance. Often these are working people who do not get health insurance from their employers but whose income is too high to qualify for public assistance via Medicaid.

Based on the latest U.S. Census Bureau estimates, the national average for uninsured people under age 65 was 10.8 percent in 2015 -- another substantial improvement over 2014 (13.5%) and again due in large part to improvements in access made possible by the Affordable Care Act (ACA, aka "Obamacare"). Virginia's rate was 10.5 percent in 2015, also a notable improvement over the 12.5 percent uninsured rate in 2014.

Because Virginia did not participate in the Medicaid expansion provision of the ACA, its relative position dropped from 20th best in the nation in 2013 to 27th best in 2015.

In comparison with its peers, Virginia had a lower percentage of uninsured individuals than North Carolina (13.1%) and Tennessee (12.0%), but higher than Maryland (7.5%). Massachusetts, which in 2006-07 began mandating that every state resident acquire healthcare coverage, again had the lowest uninsured rate -- 3.3 percent -- in the nation.

Percent of Uninsured by Virginia Region.  See text for explanation.

In 2015, local uninsured rates again dropped in every region of Virginia. The Eastern (13.4%), Southside (13.1%), Valley (12.7%), and Southwest (12.2%) regions had the highest uninsured rates. The Northern region had the lowest rate at 9.2 percent uninsured. The 2015 regional statewide average for uninsured persons under the age of 65 was 10.4 percent.

Additional Points of Interest

  • As of 2015, private health insurance covered about 59.4 percent of the U.S. population. This insurance covers families of workers and their dependents but does not cover the cost of long-term care.
  • As of 2015, the public sector -- through Medicare at the federal level and Medicaid at the state level -- provided insurance for about 35.9 percent of the population, with services targeted to vulnerable persons including the poor, elderly, and disabled. The Veterans Administration covered an additional 4.7 percent.
  • In FY 2015, enrollment in Virginia's FAMIS/SCHIP program numbered 110,056 children. From FY 2007 to FY 2015, Medicaid enrollment increased from 649,903 to 937,287.

What Influences the Health Insurance Rate?

Income Level: People with income at or below 200 percent of poverty -- in 2015 that equated to $24,662 for an individual -- are more than twice as likely to be uninsured as people at higher income levels.

Race and Ethnicity: Racial and ethnic minority groups are less likely to be insured than white Virginians.

Age: Young adults are at greater risk for being uninsured than children and older adults.

Employment Status: Unemployed individuals, part-time workers, and homemakers are at greater risk of being uninsured.

Firm Size: Employees of very small firms are typically at greater risk of being uninsured.

What is the State's Role?

Medicaid and FAMIS assist eligible Virginians whose family incomes range from 30-133 percent of the federal poverty level. Teaching hospitals, state facilities, community health centers, and free clinics offer health care services either free or at a reduced rate. Considerable attention is still needed to achieve:

  • Improved access to health care services for the uninsured
  • Strategies that encourage healthier living for all segments of the population

Although its reach in Virginia is somewhat muted, the Affordable Care Act specifically includes:

  • Strategies for improving the quality of care delivered by various health care providers
  • Policies that are geared towards more cost-effective delivery of services for aged and disabled Medicare and Medicaid recipients
Page last modified June 05, 2017
Uninsured Rates for Health Insurance, by State Uninsured Rates for Health Insurance, by Virginia Region

State rankings are ordered so that #1 is understood to be the best.

Data and Definitions

State Data: U.S. Census Bureau, American Community Survey, 1-Year Estimates (2015, Table S2701)
NOTE: ACS search results are session-based and may not result in a direct link for all users.

Regional Data: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE)
SAHIE estimates for 2008-2015 for the first time incorporated data on health insurance coverage and income group distributions from the American Community Survey (ACS), resulting in improved precision.

Virginia Department of Social Services Annual Statistical Report

Virginia Health Care Foundation, Profile of the Uninsured

See the Data Sources and Updates Calendar for a detailed list of the data resources used for indicator measures on Virginia Performs.

At a Glance:
Health Insurance in Virginia

Performance Trend: 
State Influence:  

National Ranking: Based on US Census estimates, 10.5% of Virginia residents under age 65 were uninsured in 2015, again ranking the state 27th nationally. The national average in 2015 was 10.8%.

Virginia by region: Within Virginia's regions, in 2015 the percentage of uninsured residents ranged from 9.2% to 13.4%.

State Programs & Initiatives

Authorized under Title XIX of the Social Security Act, Medicaid is a public health care program financed by states and the federal government. In Virginia, Medicaid and family health programs are administered by the Department of Medical Assistance Services.

Eligibility for Medicaid is determined by the Department of Social Services (DSS). For a list of other medical assistance programs available through DSS, go to their website.

The State Children's Health Insurance Program (SCHIP, or CHIP) is a federal-state partnership that provides health coverage to uninsured children whose families earn too much to qualify for Medicaid, but too little to afford private coverage.

Cover Virginia logo. See text for more information.

Cover Virginia connects Virginians to several programs for gaining health care services, especially the Family Access to Medical Insurance Security (FAMIS) program. FAMIS is what SCHIP is called in Virginia and helps eligible families provide health insurance for their children. Other programs within FAMIS cover pregnant mothers and dental care. Cover Virginia also connects users to and Virginia's Medicaid services.

Additional Information logo

Results so far of the Patient Protection and Affordable Care Act's mandate for personal health insurance indicate significant improvements have been made in the number of uninsured Americans -- from a high of 18.2 percent uninsured in 2013 to 10.3 percent uninsured in late 2016. Modeled after the plans implemented in Massachusetts (the national leader in covered residents since 2007), state and/or federal "exchanges" where citizens and businesses may shop for healthcare plans are active, though there is a defined enrollment period each year. Learn more at

The Virginia Health Care Foundation works to improve the lives and health of Virginia's uninsured by helping to make primary health care more available to uninsured and medically underserved Virginians.

To see how Virginia's localities stack up on access to health care and a number of other health factors and outcomes, visit County Health Rankings.