A small nail salon owner in Annandale, who purchases health insurance through the Marketplace because she lacks employer coverage, opened her insurance bill for early 2026 and found the premium had nearly doubled from the previous year. This is not an isolated case. Many Vietnamese-American families running their own businesses — from nail salons to restaurants to auto repair shops — across Northern Virginia are buying insurance through the Marketplace because it is their only option.
The problem originates in Washington, not Richmond. The federal insurance premium subsidies expanded in 2021 under the American Rescue Plan Act and extended in 2022 through the Inflation Reduction Act expired at the end of 2025 without Congress extending them further. The consequence is that Marketplace insurance premiums in Virginia rose an average of 75%, and roughly 100,000 Virginia residents lost coverage as early as late 2024 when subsidies began tightening. According to data compiled by KFF Health News, the number of insurance cancellations in Virginia doubled compared to the same period last year — among the sharpest increases in the nation.
The 150 million USD is merely a stopgap solution, not a complete recovery of lost subsidies.
Virginia responds with budget, not rhetoric
In the two-year budget recently passed by both chambers of the Virginia legislature, 150 million USD has been set aside to establish a state-level subsidy program, adding to the remaining federal subsidies. According to Keven Patchett, director of the Virginia Health Benefit Exchange, this funding is expected to reduce monthly premiums for approximately 200,000 Virginia residents with household incomes between 138 percent and 250 percent of the federal poverty level — specifically 22,025 to 39,900 USD annually for individuals, and 45,540 to 82,500 USD for a family of four.
This income range is quite common in the Vietnamese-American small business community: enough to be ineligible for Medicaid, but not enough to afford full commercial insurance premiums. The problem is that this amount falls far short of what is needed. The Virginia Health Benefit Exchange itself acknowledges needing approximately 234 million USD per year to fully offset the federal subsidies that were lost — meaning 150 million USD is merely a stopgap solution, not a complete recovery.
Who should pay attention and what to do
Open enrollment begins on November 1, and state subsidies will be displayed alongside federal subsidies when residents select insurance plans. For those who dropped coverage due to high premiums, now is the time to check again: the new subsidy levels may bring premiums back to affordable amounts. The Exchange plans to launch an outreach campaign through insurance agents (navigators) and social media to reach people who left the system — a matter of concern for the Vietnamese-American community, where information about public benefits often spreads more slowly without specific Vietnamese-language channels.
The broader context is also troubling: the federal safety net is under strain in many areas, from healthcare to food assistance. The federal SNAP program, serving approximately 42 million Americans, has also faced funding interruptions in this fiscal year, forcing some states to use local budgets to compensate — the same logic Virginia is now applying to healthcare: the state bears the burden the federal government left behind, but cannot shoulder it entirely.