EXECUTIVE ORDER 20 (2026)

KEEP VIRGINIA COVERED

By virtue of the authority vested in me as Governor under Article V of the Constitution of Virginia and under the laws of the Commonwealth, including but not limited to §§ 2.2-103 and 2.2-110 of the Code of Virginia, I hereby direct the actions below to mitigate the harms caused by the "One Big Beautiful Bill" Act ("OBBBA").

Consistent with this Order, the Commonwealth will implement the OBBBA in a manner that maximally supports continuity of coverage, protects healthcare and food assistance programs, promotes economic mobility and family well-being, and improves statewide coordination.

Importance of the Issue

Access to healthcare and food assistance is essential to the health and economic well-being of Virginians, and Virginia's economy. Over 1.8 million Virginians are enrolled in Medicaid and nearly 800,000 Virginians are enrolled in the Supplemental Nutrition Assistance Program ("SNAP").

On July 4, 2025, the federal government enacted the OBBBA, which makes the largest cuts to Medicaid and SNAP in these programs' history. The OBBBA puts Virginia's entire health and human resources system at risk due to loss of funding, structural uncertainty, and the addition of significant limits on state flexibilities for lifesaving benefit programs. Additionally, the OBBBA makes substantial changes to the administration and eligibility requirements of Medicaid and SNAP, which will result in Virginians losing health coverage and food benefits at a time when everyday living expenses are increasing and putting financial pressure on Virginians.

The OBBBA added administrative requirements, that when previously implemented in other states have resulted, not in program integrity increases, but instead in significant coverage loss for eligible members – including but not limited to individuals who are working full-time. This loss of coverage will strain Virginia's healthcare safety net and major healthcare institutions alike. Changes to Medicaid and SNAP financing will result in billions of dollars in lost federal dollars to the Commonwealth, resulting in Virginians – including those with private insurance – losing access to healthcare providers, hospitals, and other critical services needed for a healthy, productive life.

The Commonwealth is committed to being honest with its citizens: the OBBBA's federal funding reductions and eligibility reductions cannot be fully replaced through state action, philanthropic giving, or private healthcare industry investment. No combination of the tools available to the Commonwealth can close a gap of this magnitude.

While the Commonwealth will implement what has been mandated by the federal government, the Commonwealth remains committed to keeping eligible Virginians covered by minimizing coverage loss caused by the OBBBA's intentionally burdensome administrative processes. The Commonwealth will execute these mitigation strategies by streamlining processes where possible, building public-private partnerships, and leveraging resources across Virginia.

Directives

Pursuant to the authority vested in me as Chief Executive Officer of the Commonwealth and pursuant to Article V of the Constitution of Virginia, I hereby announce the Keep Virginia Covered policy, which will ensure that executive agencies prioritize continuity of coverage by minimizing administrative burdens and promoting economic mobility, family well-being, healthcare access, and affordability.

Specifically, I am directing the Secretary of Health and Human Resources, as well as agencies under the Secretariat's authority — including the Department of Medical Assistance Services ("DMAS") and the Department of Social Services ("DSS") — to implement the OBBBA in accordance with the Keep Virginia Covered policy to mitigate the most negative impacts of the OBBBA. While the Commonwealth cannot protect Virginians against all harm caused by the OBBBA, where state discretion is permissible, the Secretary of Health and Human Resources and all relevant agencies shall use the following Keep Virginia Covered policy principles to guide implementation of the OBBBA:

Keep every Virginian who remains eligible for Medicaid or SNAP enrolled and covered;

Minimize administrative and procedural barriers to enrollment and renewal wherever federal law affords the Commonwealth discretion;

Provide meaningful opportunities for economic mobility, workforce development, and employment resources;

Provide alternative opportunities for coverage and access to health and food services where feasible; and

Build public-private partnerships that bring the Commonwealth's full civic and philanthropic capacity to bear where state government alone cannot fill the gap left by federal red tape and reduced funding.

In furtherance of the Keep Virginia Covered policy, I hereby direct the following actions:

1. Advance administrative simplification: Build the systems needed to process eligibility correctly and efficiently, while leveraging available internal resources to minimize administrative burdens on Virginians.

To the fullest extent permitted under federal law, the Secretary of Health and Human Resources shall ensure that DMAS and DSS take the following actions to guide Virginians through the renewal processes for Medicaid and SNAP:

Use plain-language notices and multi-channel outreach before any coverage or benefit action is taken;

Bolster staffing at call centers and outreach navigator capacity to address increased demand;

Align and streamline redetermination, verification, and reporting processes to reduce duplicate paperwork;

Reduce application burdens by expanding the use of information Virginians have already provided or is securely available, including through collaboration with peer agencies; and

Provide a clear, accessible cure period and appeals pathway.

All executive branch agencies shall, upon request, collaborate with DMAS, DSS, and the Chief Transformation Officer to maximize the use of available information consistent with this Order.

DMAS and DSS shall continue to provide and develop additional public resources for Virginians to inform individuals about steps necessary to maintain coverage. Resources shall be publicly available by October 1, 2026.

2. Engage Community Partners and Stakeholders: Ensure that community voices are heard as part of the planning and implementation of the OBBBA.

I hereby direct the Secretary of Health and Human Resources to engage representatives from hospitals, safety net providers, Managed Care Organizations, Federally Qualified Health Centers, Community Services Boards, free clinics, food banks, and other stakeholders to inform policy and implementation processes and coordinate on the challenges leading up to and following implementation of the OBBBA. This coordination shall also satisfy the OBBBA's requirement for dedicated coordination between state agencies and Virginia's health care system and other stakeholders.

DMAS shall host virtual town halls to inform the public and health providers across the Commonwealth of new requirements, how to meet the requirements, and how to report changes to the Commonwealth to ensure that individuals who remain eligible also remain enrolled. Additionally, the Secretary of Health and Human Resources, in collaboration with DSS and DMAS, shall hold regional outreach workshops in locations across the Commonwealth to inform local responses to the detrimental impacts of the OBBBA and strengthen public-private partnerships as a means to mitigate those impacts.

Additionally, DMAS and DSS shall promote data transparency to enable greater collaboration across entities. To facilitate this, DMAS and DSS are directed to regularly update and publish data on Medicaid and SNAP enrollment and "at-risk" members to inform community partners of the impact of the OBBBA.

3. Promote Economic Mobility: Provide meaningful opportunities for economic mobility through enhanced employment, Registered Apprenticeship, and education resources to mitigate the effects of the OBBBA.

The Secretary of Health and Human Resources, in coordination with the Secretary of Labor and the Secretary of Education, shall take the following additional actions to drive economic mobility for Virginians despite the negative effects of the OBBBA and to ensure that Virginians take advantage of new opportunities to earn a living wage, develop new skills, and retain benefits:

Expand and improve resources connecting Virginians to available employment, volunteer, Registered Apprenticeship, job training, and education opportunities; and

Expand case management and resource coordination for Virginians subject to new Medicaid and SNAP work requirements to prioritize individuals with greatest needs.

4. Provide alternative coverage options and access to services where feasible: Collaborate with other state entities and private partners to offer alternative solutions for individuals no longer able to access Medicaid or SNAP benefits.

The Secretary of Health and Human Resources, in coordination with DMAS and DSS, shall take the following steps to ensure Virginians are connected to available solutions:

Collaborate with the State Corporation Commission and Virginia's Health Benefit Exchange to implement the state-created $150 million Virginia Premium Support Program to support the implementation of affordable health coverage after federal inaction skyrocketed costs;

Coordinate warm handoffs and outreach on coverage changes across Virginia's agencies and with stakeholders across Virginia's health care infrastructure and safety net; and

Partner with philanthropy and community-based organizations, Federally Qualified Health Centers, free clinics, and food banks to support innovative solutions to address surge in demand at a time of dwindling funding.

5. Maximize use of available funding to effectively implement the Keep Virginia Covered policy: Use appropriated funds to prioritize implementation of the Keep Virginia Covered policy in alignment with the principles described herein.

In addition to the funding request process established by Item 471 M 2 of House Bill 30 (i.e., the Budget Bill), and without prejudicing any requests received under the existing application process, the Secretary of Finance and the Department of Planning and Budget ("DPB") shall prioritize proposed uses of the Federal Uncertainty Contingency Fund that best advance the goals of this Order. The Secretary of Finance and DPB shall review agency requests for funding on an ongoing basis and communicate recommendations to the Chairs of the House Appropriations and Senate Finance and Appropriations Committees as necessary to protect Virginians from ongoing federal uncertainty and to support the implementation of the Keep Virginia Covered policy. See Nelms v. Vaughn, 84 Va. 696, 700 (1888) ("Generally the rule is where a statute specifies a time within which a public officer is to perform an act regarding the rights and duties of others, it will be considered as merely directory . . . .").

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The Secretary of Health and Human Resources shall provide quarterly updates to the Office of the Governor on the progress of the actions described above, including but not limited to coverage losses, outreach efforts and campaigns, and budget implications.

Effective Date of the Executive Order

This Executive Order shall become effective upon its signing and shall remain in full force and effect until amended or rescinded by further executive order

Given under my hand and under the Seal of the Commonwealth of Virginia this 25th day of August 2026.

/s/ Abigail D. Spanberger, Governor