Topurchase license plates or decals, you must certify that the vehicle is covered by the minimum insurance requirements. Insurance requirements also apply to antique motor vehicles. Your insurance carrier must be authorized to conduct business in Virginia.
Insurance companies may factor in their policy premium the driving record of any individual of driving age that resides within an insured's household. If you have any questions regarding the potential impact a newly licensed driver may have on your policy, you may wish to contact your insurance agent.
In partnership with the insurance industry, the Virginia Department of Motor Vehicles (DMV)administers a program to electronically verify the automobile liability insurance on Virginia registered vehicles. If no insurance is found for a particular motor vehicle, the owner is required to furnish policy information to DMV for verification. For more information, refer to Verification of Insurance Coverage.
The income limits are based on Modified Adjusted Gross Income or MAGI limits. The limits are referred to as MAGI because the programs using MAGI limits are based primarily on IRS rules for counting income and determining household composition.
CHIP provides health coverage for uninsured children up to age 19 years old. To be eligible for CHIP, a child cannot be eligible for Medicaid. At the time of application, children with health insurance are not eligible for CHIP.
CHIP is currently administered by two coordinated care organizations (CCOs). New CHIP contracts with Molina Healthcare and UnitedHealthcare Community Plan will take effect Nov. 1, 2019. CHIP beneficiaries currently enrolled with the outgoing CHIP CCO, Magnolia Health Plan, will receive a letter giving them the opportunity to choose between Molina Healthcare and UnitedHealthcare Community Plan. If a CHIP beneficiary does not respond, they will be assigned to Molina Healthcare.
Two states (South Dakota and North Carolina) implemented Medicaid expansion in 2023, reducing the number of low-income uninsured people nationally without access to Medicaid. Expansion in those two states brings the count to 40 states and the District of Columbia that have adopted expansion, leaving ten states that have not adopted it. Using data from 2022, the most recent year available, this brief presents estimates of the number and characteristics of uninsured people in the ten non-expansion states who could be reached by Medicaid if their states adopted the Medicaid expansion. An overview of the methodology underlying the analysis can be found in the Data and Methods, and more detail is available in the Technical Appendices.
The coverage gap exists in states that have not adopted the ACA Medicaid expansion for adults who are not eligible for Medicaid coverage or subsidies in the Marketplace. The ACA expanded Medicaid to nonelderly adults with income up to 138% FPL ($20,782 annually for an individual in 2024) with enhanced federal matching funds (now at 90%). The Medicaid expansion established a uniform eligibility threshold across states for low-income parents and newly established Medicaid coverage for adults without dependent children. However, the expansion is effectively optional for states because of a 2012 Supreme Court ruling. As of February 2024, 40 states and DC have expanded Medicaid (Figure 1).
States that have not implemented the expansion have uninsured rates that are nearly double the rate of expansion states (14.1% compared to 7.5%). People without insurance coverage have worse access to care than people who are insured. One in five uninsured adults in 2022 went without needed medical care due to cost and uninsured people are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.
Nearly three-quarters of adults in the coverage gap are concentrated in three states in the South. Four in ten people in the coverage gap reside in Texas, which has very limited Medicaid eligibility, and consequently, a large uninsured population (Figure 4). An additional 19% of people in the coverage gap live in Florida and 12% live in Georgia. In total, 97% of those in the coverage gap live in the South. Seven of the 16 states in the South have not adopted the Medicaid expansion, and the region has more low-income, uninsured adults and higher uninsured rates compared to other regions.
People in the coverage gap are disproportionately people of color. Nationally, over six in ten (62%) people in the coverage gap are people of color, a share that is higher than for non-elderly adults generally in non-expansion states (53%) and for non-elderly adults nationwide (46%) (Figure 5). These differences in part explain persisting disparities in health insurance coverage by race/ethnicity.
Despite having low income, nearly six in ten people in the coverage gap are in a family with a worker, and over four in ten are working themselves (Figure 6). Adults who work may still have incomes below poverty because they work low-wage jobs. People with incomes below poverty often do not have access to employer based health insurance or if available, it is often unaffordable. The most common jobs among adults in the coverage gap are cashier, cook, waiter/waitress, construction laborer, maid/housecleaner, retail salesperson, and janitor. For parents in non-expansion states, even part-time work may make them ineligible for Medicaid.
Some people in the coverage gap have significant current health care needs. KFF analysis of the 2022 American Community Survey shows that more than one in six (17%) people in the coverage gap have a functional disability, meaning they have serious difficulty with hearing, vision, cognitive functioning, mobility, self-care, or independent living. Even with functional disabilities, many are not able to qualify for Medicaid through a disability pathway leaving them uninsured. Older adults, age 55-64, an age of increasing health needs, make up 18% of people in the coverage gap. Research has demonstrated that uninsured people in this age range may leave health needs untreated until they become eligible for Medicare at age 65.
If all states adopted the Medicaid expansion, approximately 2.9 million uninsured adults would become newly eligible for Medicaid. This number includes the 1.5 million adults in the coverage gap and an additional 1.4 million uninsured adults with incomes between 100% and 138% FPL, most of whom are currently eligible for Marketplace coverage but not enrolled (Figure 7 and Table 1). Most of the adults who are currently eligible for coverage in the Marketplace qualify for plans with zero premiums; however, even with no premiums, Medicaid could provide more comprehensive benefits and lower cost-sharing compared to Marketplace coverage. The potential number of people who could be reached by Medicaid expansion varies by state.
A substantial body of research continues to point to largely positive effects from the Medicaid expansion. KFF reports published in 2020 and 2021 reviewed more than 600 studies and concluded that expansion is linked to gains in coverage, improvement in access and health, and economic benefits for states and providers. More recent studies generally find positive effects related to more specific outcomes such as improved access to care, treatment and outcomes for cancer, chronic conditions, sexual and reproductive health and behavioral health. Studies also point to evidence of reduced racial disparities in coverage and access, reduced mortality and improvements in economic impacts for providers (particularly rural hospitals) and economic stability for individuals.
Renewed debates over Medicaid expansion could lead to additional states adopting the expansion. Legislative opposition to expansion may be softening in some states, driven by financial challenges facing rural hospitals as well as interest in taking advantage of the additional federal funding. If additional states were to expand Medicaid, it could help limit increases in the number of people who become uninsured because of the unwinding of the Medicaid continuous enrollment provision. In South Dakota and North Carolina, Medicaid enrollment dropped initially after the start of the unwinding, but began increasing again following implementation of Medicaid expansion in each state.
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Marketing assistance loans allow farmers to obtain a short-term (usually up to 9 months) low-interest loan for their harvested commodity at the posted county loan rate, with the option of repaying at a lower rate with interest waived if the posted county market price falls below the loan rate (repayment rates for upland cotton and rice are based on international market prices). Producers also have the option to forfeit their commodities that are under loan as a full payment of their loan. Producers who choose not to take out a loan may receive the same benefit by collecting a direct loan deficiency payment (LDP) on their harvested commodity equal to the difference between the loan rate and the market price.
Noninsured Crop Disaster Assistance Program (NAP) payments are made to producers of crops for which crop insurance is unavailable in that county. NAP was created by the 1994 Federal Crop Insurance Reform Act and originally contained an area-yield-loss trigger in addition to a farm-yield-loss trigger. The area-yield-loss requirement was eliminated in the Agricultural Risk Protection Act of 2000. The Agricultural Act of 2014 expanded the program by allowing additional coverage above catastrophic levels for commodities that otherwise would not have additional coverage available to them. Producers pay a service fee for basic coverage of 50 percent of the crop at 55 percent of the price and a premium fee of 5.25 percent of the liability for up to 65 percent of the crop at 100 percent of the price. Payments under NAP cannot exceed $125,000 per individual or entity for a single crop year.
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