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. Over one million Virginians 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 (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 17.7 percent in 2012. In the same year, Virginia's rate was 14.2 percent, ranking it 16th among all the states; this marks an improvement from 2011, when over 15 percent of Virginians were uninsured.

In comparison with its peers, Virginia had a lower percentage of uninsured individuals than North Carolina (20.2%) and Tennessee (16.1%), but a bit higher than Maryland (14.1%). Massachusetts, which in 2006-07 began mandating that every state resident acquire healthcare coverage, again had the lowest uninsured rate -- 4.9 percent -- in the nation.

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

In 2012, uninsured rates rose slightly in six regions, but dropped modestly in the Hampton Roads and Valley regions. The Southside (18.0%), Eastern (17.6%), Southwest (17.0%), and Valley (16.7%) regions had the highest uninsured rates. The Northern region had the lowest rate at 12.6 percent uninsured. The regional statewide average for uninsured persons under the age of 65 was 14.2 percent.

Additional Points of Interest

  • As of 2012, the private sector insured about 58 percent of Virginia's population (a drop of nearly 10 percentage points since 2001). This insurance covers families of workers and their dependents but does not cover the cost of long-term care.
  • As of 2012, the public sector -- through Medicare at the federal level and Medicaid at the state level -- provided insurance for about 19 percent of the population, with services targeted to vulnerable persons including the poor, elderly, and disabled.
  • From FY 2007 to FY 2012, enrollment in Virginia's FAMIS/SCHIP program increased from 80,024 children to 110,149 children. Medicaid enrollment increased from 649,903 to 834,836 during the same period. The rate of Virginians dependent on Medicaid has increased from 8 to 11 percent since 2007, thanks largely to the recent recession and continued slow job growth.
  • Nationally as of 2012, about 7 percent of the population under age 65 paid for medical insurance out of their own pockets. Nearly 18 percent of the population was uninsured. However, preliminary results after a year under the Affordable Care Act indicate that the uninsured population has dropped to 13.4 percent.

What Influences the Health Insurance Rate?

Income Level: People with income at or below 200 percent of poverty -- in 2013 that equated to $22,980 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. 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 January 06, 2015
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

NOTE: Although the Affordable Care Act requires most individuals without employer-provided plans to purchase insurance, that part of the law went into effect in late 2013 and is not yet reflected in our data sources.

State Data: CDC Historic Health Insurance Tables
www.census.gov/hhes/www/hlthins/data/historical/HIB_tables.html

Gallup: In U.S., Uninsured Rate Holds at 13.4 Percent

Regional Data: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE)
www.census.gov/hhes/www/sahie/index.html
SAHIE estimates for 2008-2010 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
www.dss.virginia.gov/geninfo/reports/agency_wide/asr.cgi

Virginia Health Care Foundation, Statistics and Information
www.vhcf.org/about/StatsandStudies.php

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: Trend is maintaining.
State Influence:  
significant

National Ranking: Based on U.S. Census estimates, 14.2% of Virginia residents under age 65 were uninsured in 2012, ranking the state 16th nationally. The national average in 2012 was 17.7%.

Virginia by region: Within Virginia's regions, in 2012 the percentage of uninsured residents ranged from 12.6% to 18.0%.

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.

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 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 Healthcare.gov and Virginia's Medicaid services.

Additional Information
Healthcare.gov logo

Preliminary results 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 percent uninsured in 2013 to 13.4 percent uninsured in 2014. 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 Healthcare.gov.

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.