On Aug. 25, 2025, Gov. Abigail Spanberger signed Executive Order 20 to strengthen Virginia’s response to federal Medicaid and Supplemental Nutrition Assistance Program (SNAP) reductions enacted through House Resolution 1 (H.R.1).

H.R.1 cuts approximately $1 trillion from Medicaid nationwide over 10 years, with Virginia facing $1.8 to $2.6 billion per year in lost federal funding beginning in 2028. Roughly 300,000 Virginians are at risk of losing Medicaid coverage. In response, Gov. Spanberger issued an executive order establishing the “Keep Virginia Covered” policy, directing cabinet secretaries and state agencies to prioritize continuity of coverage, reduce administrative burdens and promote healthcare access and affordability as Virginia implements the federal One Big Beautiful Bill Act (OBBBA).

The “Keep Virginia Covered” Policy: Core Principles

The executive order outlines policy principles to guide the commonwealth’s implementation and directs five actions to mitigate impacts on Virginians currently enrolled in Medicaid or SNAP. Under the order, implementation will be guided by the following principles:

• 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 opportunities for economic mobility, workforce development and employment resources.
• Provide alternative opportunities for coverage and access to health and food services where feasible.
• Build public-private partnerships to help bridge the gap left by the implementation of the OBBBA.

To carry out these principles, the order directs five actions:

Advance Administrative Simplification

A central theme of the order is administrative simplification to avoid unnecessary disenrollment. Before taking any coverage or benefit action, the Department of Medical Assistance Services (DMAS) and Department of Social Services (DSS) must use clear notices and outreach across multiple channels to guide Virginians through Medicaid and SNAP renewals.

They will also bolster call center staffing and navigator capacity, align redetermination and verification processes to eliminate duplicate paperwork, expand use of information already on file or available through peer agencies and provide clear cure periods and appeals pathways.

All executive branch agencies are directed to collaborate with DMAS, DSS and the chief transformation officer to maximize lawful data sharing and process improvement. Public resources explaining how to maintain coverage must be available by Oct. 1, 2026.

For employers and providers, these measures aim to reduce disruptions in coverage that can translate into workforce instability, bad debt and operational strain.

Engage Community Partners and Stakeholders

The order requires sustained engagement with community partners and stakeholders to ensure implementation reflects on-the-ground realities. The secretary of Health and Human Resources must engage hospitals, safety net providers, Managed Care Organizations (MCOs), Federally Qualified Health Centers (FQHCs), Community Services Boards, free clinics, food banks and other stakeholders to inform OBBBA planning and implementation. DMAS is directed to host virtual town halls on new requirements and reporting obligations. Regional outreach workshops will strengthen public-private partnerships. DMAS and DSS must publish and regularly update data on Medicaid and SNAP enrollment and at-risk member data to support community collaboration.

Businesses and nonprofits can expect increased opportunities and requests for collaboration, data-informed outreach and coordinated responses to coverage losses.

Promote Economic Mobility

Recognizing that new work-related requirements under OBBBA may affect benefits, the order explicitly links coverage continuity with economic mobility. The secretaries of Health and Human Resources, Labor and Education must expand resources connecting Virginians to employment, registered apprenticeship, job training, volunteer and education opportunities. Agencies must expand case management for individuals subject to new Medicaid and SNAP work requirements, prioritizing those with the greatest needs.

These measures seek to help beneficiaries navigate new requirements, maintain benefits where possible and access pathways to higher earnings.

Provide Alternative Coverage Options and Access to Services

For individuals who lose Medicaid or SNAP under OBBBA, the order calls for an ecosystem of alternative supports.

The secretary of Health and Human Resources must collaborate with the State Corporation Commission and Virginia’s Health Benefit Exchange to implement the $150 million Virginia Premium Support Program for affordable coverage. They will coordinate warm handoffs across state agencies and healthcare stakeholders on coverage changes and partner with philanthropy, community-based organizations, FQHCs, free clinics and food banks to address surging demand.

Health plans, providers, community organizations and philanthropic entities may see new opportunities to participate in coverage navigation and service delivery innovations.

Maximize Available Funds to Implement the “Keep Virginia Covered” Policy

The order also addresses how Virginia will prioritize limited state resources.

The secretary of Finance and Department of Planning and Budget is directed to prioritize proposed uses of the Federal Uncertainty Contingency Fund, which has $225 million allocated in the state budget, to advance the “Keep Virginia Covered” policy. Agency funding requests will be reviewed on an ongoing basis, with recommendations communicated to legislative budget leaders to protect Virginians from federal uncertainty.

The order is effective immediately and remains in force until amended or rescinded. Key oversight mechanisms include quarterly reporting by the secretary of Health and Human Resources to the governor’s office on coverage losses, outreach efforts and budget implications.

For organizations operating in Virginia’s healthcare, human services and workforce ecosystems, Executive Order 20 sets a clear direction. The commonwealth will comply with federal mandates under OBBBA, while using all available discretion to preserve coverage, reduce administrative burdens and support economic mobility. The order also calls on private and nonprofit partners to help keep Virginians connected to essential health and food assistance.

Executive Order 20 “Keep Virginia Covered” policy can be found here.