Virginia Hospitals Report 49% Increase in Self-Paying ER Visits Amid Medicaid Cuts
The Virginia Hospital and Healthcare Association (VHHA) has reported a significant rise in the number of self-paying emergency room visits in Virginia, with a 49% increase from 2022 to 2025. In 2025, 405,584 ER visits were classified as self-pay, marking a four-year high. This surge is occurring ahead of the implementation of H.R. 1, a budget reconciliation legislation that is expected to cut Medicaid funding by nearly a trillion dollars over a decade. The VHHA attributes part of this increase to the end of COVID relief subsidies that helped people maintain insurance through the Affordable Care Act marketplaces. As a result, many did not renew their plans, leading to a higher uninsured rate. Over the past four years, Virginia hospitals have recorded over 1.35 million self-pay ER visits, accounting for nearly 10% of all emergency department encounters. 
