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FACT SHEET: Health Care in Virginia


From the White House: 

FACT SHEET: Health Care in Virginia

What the Affordable Care Act is doing for Virginia families

The Affordable Care Act has already covered one in four uninsured Americans – more than ten million – and improved coverage for virtually everyone with health coverage. Insurers can no longer discriminate against preexisting conditions, charge women more just for being women, or put caps on the care you receive. Hospitals, doctors and other providers are changing the way they operate to deliver better care at lower cost. In the years to come, the ability to buy portable and affordable plans on a competitive marketplace will allow countless Americans to move, start businesses, and dream big American dreams — without worrying if an illness will bankrupt them. Here is how the Affordable Care Act is working for families in Virginia:


After Health Reform: Improved Access to Care 

·         And Gallup recently estimated that the uninsured rate in Virginia in 2014 was 13 percent, down from 13.3 percent in 2013. 

·         Prohibits coverage denials and reduced benefits, protecting as many as 3,491,076 Virginians who have some type of pre-existing health condition, including 437,558 children.

·         Eliminates lifetime and annual limits on insurance coverage and establishes annual limits on out-of-pocket spending on essential health benefits, benefiting 2,974,000 people in Virginia, including 1,121,000 women and 817,000 children. 

·         Expands Medicaid to all non-eligible adults with incomes under 133% of the federal poverty level.  If Virginia expands Medicaid, an additional 180,000 uninsured people would gain coverage. 

·         Establishes a system of state and federal health insurance exchanges, or marketplaces, to make it easier for individuals and small-business employees to purchase health plans at affordable prices through which 335,033 people in Virginia were covered in March 2015. 

·         Created a temporary high-risk pool program to cover uninsured people with pre-existing conditions prior to 2014 reforms which helped more than 3,252 people in Virginia. 

·         Creates health plan disclosure requirements and simple, standardized summaries so 4,969,900 people in Virginia can better understand coverage information and compare benefits. 


After Health Reform: More Affordable Care


·         Creates a tax credit to help 285,938 people in Virginia who otherwise cannot afford it purchase health coverage through health insurance marketplaces. 

·         Requires health insurers to provide consumers with rebates if the amount they spend on health benefits and quality of care, as opposed to advertising and marketing, is too low.  Last year, 104,774 consumers in Virginia received $8,913,605 in rebates. 

·         Eliminates out-of-pocket costs for preventive services like immunizations, certain cancer screenings, contraception, reproductive counseling, obesity screening, and behavioral assessments for children.  This coverage is guaranteed for more than 3,902,716 people in Virginia including 1,587,663 women. 

·         Eliminates out-of-pocket costs for 943,647 Medicare beneficiaries in Virginia for preventive services like cancer screenings, bone-mass measurements, annual physicals, and smoking cessation. 

·         Phases out the “donut hole” coverage gap for 111,997 Medicare prescription drug beneficiaries in Virginia, who have saved an average of $914 per beneficiary. 


·         Creates Accountable Care Organizations consisting of doctors and other health-care providers who share in savings from keeping patients well while improving quality, helping 279,319 Medicare beneficiaries in Virginia.


·         Phases out overpayments through the Medicare Advantage system, while requiring Medicare Advantage plans to spend at least 85 percent of Medicare revenue on patient care.  Medicare Advantage enrollment has grown by 88,201 to 237,689 in Virginia since 2009.


After Health Reform: Improved Quality and Accountability to You


·         Provides incentives to hospitals in Medicare to reduce hospital-acquired infections and avoidable readmissions.  Creates a collaborative health-safety learning network, the Partnership for Patients, that includes 69 hospitals in Virginia to promote best quality practices. 


We're not done.  Other legislation and executive actions are continuing to advance the cause of effective, accountable and affordable health care.This includes:


·         Incentive payments for doctors, hospitals, and other providers to adopt and use certified electronic health records (EHR).  In Virginia more than 65.2 percent of hospitals and 51.2 percent of providers have electronic health records systems. 

·         A new funding pool for Community Health Centers to build, expand and operate health-care facilities in underserved communities.  Health Center grantees in Virginia now serve 286,604 patients and received $173,538,756 under the health care law to offer a broader array of primary care services, extend their hours of operations, hire more providers, and renovate or build new clinical spaces. 

·         Health provider training opportunities, with an emphasis on primary care, including a significant expansion of the National Health Service Corps.  As of September 30, 2014, there were 108 Corps clinicians providing primary care services in Virginia, compared to 52 clinicians in 2008. 


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