Virginia does not require you to have health insurance, and there is no state or federal penalty for going without coverage. The federal individual mandate technically still exists as law, but the Tax Cuts and Jobs Act of 2017 reduced the penalty to $0 starting in 2019. Virginia has not created its own state-level mandate to replace it, so you will not owe anything on your federal or Virginia tax return for being uninsured.
Why the Mandate No Longer Has Teeth
The Affordable Care Act originally required most Americans to carry minimum essential health coverage or pay a tax penalty. That changed when Congress zeroed out the penalty for the 2019 tax year and beyond. The law still says you should have coverage, but the IRS confirms there is no shared responsibility payment to make and no special form to file if you go without it.
Some states, including Massachusetts, New Jersey, California, and the District of Columbia, passed their own mandates with real financial penalties. Virginia is not one of them. The CoverVA website, run by the state’s Department of Medical Assistance Services, states plainly: “There is no longer a penalty for not having health insurance.”
What Virginia Does Report to the IRS
Even without a penalty, Virginia still tracks and reports your coverage. If you were enrolled in Medicaid, FAMIS (the state children’s health program), employer-sponsored insurance, or a marketplace plan during the year, you’ll receive a 1095 tax form by January 31. The state sends the same information directly to the IRS. You should keep this form with your tax records, though you won’t be penalized for lacking one.
If you or your dependents had more than one type of coverage during the year, expect multiple 1095 forms. Limited-coverage Medicaid programs do not generate a 1095-B.
Coverage Options If You Want Insurance
Just because Virginia doesn’t require coverage doesn’t mean it’s hard to get. The state runs its own marketplace at Marketplace.Virginia.gov, where you can compare plans and check whether you qualify for subsidies that lower your monthly premium.
Medicaid
Virginia expanded Medicaid in 2019, which opened coverage to a much larger group of residents. Adults aged 19 to 64 with household income at or below 138% of the federal poverty level qualify. Children under 19 qualify at incomes up to 143% of the poverty level, and the same threshold applies to pregnant women. Former foster care children under age 26 who were in Medicaid-funded foster care when they turned 18 qualify regardless of income. These thresholds include a built-in 5% income buffer, so you may still qualify even if your income sits slightly above the stated limit.
Marketplace Plans
For those who earn too much for Medicaid, Virginia’s Insurance Marketplace offers private plans at various price points. Many residents qualify for premium tax credits that significantly reduce monthly costs, especially if the cheapest available plan would cost more than about 8% of household income.
When You Can Enroll
Open enrollment for 2026 coverage runs from November 1, 2025, through January 30, 2026. That’s a full three months, two weeks longer than in previous years. If you enroll by December 31, 2025, your coverage starts January 1, 2026. If you enroll during January, coverage begins February 1, 2026.
Outside of open enrollment, you can still sign up if you experience a qualifying life event. These fall into four categories:
- Loss of coverage: losing Medicaid, employer insurance, or other minimum essential coverage
- Household changes: marriage, divorce, birth, adoption, legal separation, death in the family, or gaining a court-appointed dependent
- Moving: relocating into Virginia or changing your address within the state
- Other changes: a significant income change, a child aging off a parent’s plan at 26, a change in citizenship or legal status, or release from incarceration
The Risk of Going Uninsured
No penalty doesn’t mean no consequences. A single emergency room visit in Virginia can easily run into tens of thousands of dollars. Without insurance, you’re responsible for the full negotiated or billed amount. Uninsured individuals also tend to delay preventive care, which can turn manageable conditions into expensive, harder-to-treat ones.
If cost is the main barrier, it’s worth checking your options before assuming you can’t afford a plan. Medicaid covers a wide income range in Virginia, and marketplace subsidies can bring premiums down to $0 for lower-income households. You can run the numbers at Marketplace.Virginia.gov without committing to anything.