Profile of Virginia’s Uninsured

The Virginia Health Care Foundation’s Profile of Virginia’s Uninsured provides a detailed picture of the Commonwealth’s uninsured, using the American Community Survey (ACS) of the US Census and the Behavioral Risk Factor Surveillance Survey – both conducted in 2023.

The 2025 Profile shows the lowest uninsured rates in Virginia since the Virginia Health Care Foundation (VHCF) began tracking them in 1996 (7.6% or 530,000 of nonelderly Virginians). It includes slides, maps and detailed tables describing the uninsured who are income-eligible for Virginia’s Cardinal Care [Medicaid and Virginia’s children’s health insurance program (CHIP) also known as FAMIS].

Note: This year’s Profile does not include adjustments for potential misreporting of Medicaid/CHIP coverage, similar to the Profiles released in 2023 and 2024. The Medicaid/CHIP continuous coverage requirement implemented in response to the COVID-19 pandemic increased the apparent misreporting of Medicaid/CHIP coverage and made the Urban Institute’s usual adjustment methodology less effective.

For a thorough examination of the demographic characteristics of Virginia’s uninsured, see:

  • A summary of key findings and maps (PowerPoint)
  • The report (Adobe)
  • The accompanying tables (Adobe)

Please cite the Virginia Health Care Foundation and Urban Institute when using data from the 2025 Profile of Virginia’s Uninsured. When using PowerPoint slides from the Profile, please use the complete slide using notes and citations from the Urban Institute.

2025 Profile Highlights

  • 7.6% or 530,000 of all nonelderly Virginians had no health insurance in 2023.
    • 8.7% of Virginians, ages 19 to 64, had no health insurance — 439,000 non-elderly adult Virginians.
    • 4.6% of Virginians birth through age 18 had no health insurance – 92,000 children.
  • Most nonelderly uninsured Virginians are income-eligible for Medicaid/CHIP or a financial subsidy on the Health Insurance Marketplace (children: 79.7%; nonelderly adults: 84.7%).
    • 163,000 nonelderly adults are income-eligible for adult Medicaid. This is about a third uninsured Virginians, ages 19 – 64 (32.6%).
    • 46,000 uninsured children are income-eligible for Medicaid/CHIP, representing half of uninsured Virginia children (49.7%).
  • The majority of uninsured Virginians under age 65 were part of working families (6%, 445,000) — most with at least one full time worker (87.6%, 390,000).

Note: The federal continuous coverage provisions increased the potential misreporting of Medicaid/CHIP coverage. The ACS estimates in this analysis do not include additional Urban Institute adjustments for potential misreporting of Medicaid/CHIP coverage. Estimates of Virginia’s uninsured developed using US Census data collected during the COVID-19 pandemic and the pandemic-related continuous coverage provision period (2021-2025) cannot be compared to estimates in pre-2021 Profiles of Virginia’s Uninsured.

Policies Leading to Lower Number of Uninsured Virginians:

  • Allowing young adults to stay on their parents’ health insurance plan until age 26 beginning in 2010 under the Affordable Care Act (ACA).
  • Introduction of subsidized coverage available through new Marketplaces beginning in 2014 under the ACA.
  • The state’s expansion of Medicaid to include low-income nonelderly adults in 2019.
  • The federal continuous coverage provisions during the COVID-19 pandemic (2020-2023).
  • The state’s extension of post-partum Medicaid coverage to 12 months in 2022.
  • Expanded Marketplace subsidies under the American Rescue Plan Act and Inflation Reduction Act (2021-2025).

What is the Impact of Being Uninsured?

  • Uninsured do not receive the care they need: Uninsured Americans are less likely to get care due to injury or illness and preventive care than those with insurance.  (Source: Kaiser Family Foundation, 2024).
  • Financial implications can be significant: Many uninsured Americans encounter unaffordable bills and accrue debt from medical or dental bills. (Source:  Kaiser Family Foundation, 2024).
  • Children with health insurance have better health, behavioral health and educational outcomes: When children have health insurance and can access needed care, they have improved health, education and financial success over the long-term.  (Source: Annie E. Casey Foundation, 2023)

The Profile of Virginia’s Uninsured was prepared for the Virginia Health Care Foundation by the Urban Institute and completed in March 2025. For more information on the study, methodology or results, contact VHCF at 804/828-5804 or dkonrad@vhcf.org.

Last Updated on April 3, 2025