Quick answer
The 21,000 figure is a projection, not a verified count of VA-02 residents already removed from health insurance. A May 2025 Joint Economic Committee Minority analysis of an earlier House legislative package estimated 19,194 district residents could lose coverage—7,600 through Affordable Care Act coverage and 11,594 through Medicaid. The final law changed during the legislative process. CBO later estimated that the enacted law's Medicaid provisions would increase the national uninsured population by 7.5 million in 2034. Kiggans did vote for final passage, but the vote was on the full reconciliation package, not a stand-alone Medicaid bill.
The story
Elaine Luria's campaign says Rep. Jen Kiggans voted to kick 21,000 people in Virginia's 2nd District off health insurance. The underlying policy is real, but the number is an estimate of future coverage losses, not a count of 21,000 people already removed from insurance. [1][6]
The claim
Recent Luria campaign advertising says Kiggans voted to "kick 21,000 Virginians in VA-02 off their health insurance." [6]
Kiggans voted for final passage of the 2025 reconciliation law, Public Law 119-21, which made substantial changes to Medicaid eligibility, enrollment and financing. [2]
What federal analysts project
The Congressional Budget Office estimates that the Medicaid provisions of the enacted law will reduce Medicaid enrollment nationally and increase the number of people without health insurance by 7.5 million in 2034 compared with its prior baseline. [1]
That is a projection, not a count of people who have already lost insurance.
District estimates require additional caution. A May 2025 Joint Economic Committee minority analysis of an earlier House legislative package estimated that about 19,194 VA-02 residents could lose health coverage, including an estimated 11,594 losing Medicaid and 7,600 losing Affordable Care Act coverage. The final law changed during the legislative process, so an estimate for an earlier bill should not automatically be presented as the precise effect of the enacted law. [3]
Other analyses have estimated how many Medicaid expansion enrollees in individual congressional districts are at risk from the final law's work requirements. "At risk of losing coverage" is also not the same as a confirmed future loss.
What is happening now
Virginia began implementing the enacted law on Oct. 1, 2026, with narrower full-benefit Medicaid eligibility for some noncitizen adults. Much broader changes begin Jan. 1, 2027, when certain Medicaid expansion adults become subject to federal work requirements and six-month eligibility reviews. [4]
Virginia therefore does not currently have a verified count showing that 21,000 VA-02 residents have been removed from health insurance because of Kiggans' vote.
The causal link
Kiggans' vote is straightforward to document: she voted for final passage of the reconciliation package containing the Medicaid changes. [2]
It is also fair to connect projected coverage effects of the law to enactment of that legislation. But no individual House member alone determines the national effect of a law passed by both chambers and signed by the president.
Bottom line
The ad is grounded in a real vote and in analyses projecting substantial future insurance losses from federal health-policy changes. But "kicking 21,000 people off their health insurance" compresses a forecast into language that can sound like an accomplished event. The precise VA-02 total depends on the estimate and version of the legislation being measured. As of October 2026, 21,000 is not a documented count of district residents already removed from coverage.
Sources
- Public Law 119-21, to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14 Title VII, Finance, Subtitle B, Health, Chapter 1, Medicaid — Congressional Budget Office. CBO estimates that the combined Medicaid provisions of enacted Public Law 119-21 will increase the number of people without health insurance by 7.5 million in 2034.
- House Roll Call Vote 190 — Congress.gov. The House agreed to the Senate amendment to H.R. 1 by 218-214; Jen Kiggans voted Aye.
- Congressional District Data - 13.7 Million People Would Lose Health Insurance From Medicaid, ACA Cuts — Joint Economic Committee Minority. The May 2025 analysis estimates 7,600 VA-02 residents losing ACA coverage and 11,594 losing Medicaid coverage, 19,194 total, based on an earlier legislative package and modeling assumptions.
- H.R. 1 Federal Work Requirement, Six-Month Renewals, and Medicaid Eligibility Changes for Non-Citizen, Non-Pregnant Adults — Virginia Department of Medical Assistance Services. Virginia's noncitizen eligibility changes begin October 1, 2026; Medicaid Expansion work requirements and six-month renewals begin January 1, 2027.
- Rep. Jen Kiggans Votes Yes On Landmark Legislation — Office of Rep. Jen Kiggans. Kiggans's official statement confirms her H.R. 1 vote and says the bill preserves Medicaid for people who truly need it while strengthening work requirements.
- Video: Elaine Luria Out with Two New Ads; Hits Jen Kiggans for Kicking 21,000 Virginians in VA-02 Off Their Health Insurance — InsuranceNewsNet. Reporting identifies the Luria campaign ad and its quoted 21,000 health-insurance claim; the full article is subscriber-gated.