CHARLOTTESVILLE, Va. _ When Garnett and Dave Mellen sent their 19-year-old daughter, Gita, off to college an hour away at Virginia Commonwealth University last fall, they didn't expect to follow her.
But in November, the family received notice that its monthly health insurance premium in Charlottesville would triple for 2018, from $1,200 to an unaffordable $3,600.
So, the Mellens, both longtime local business owners, packed their bags and spent time with Gita in her off-campus apartment in Richmond.
"My whole life has been rearranged around trying to get health insurance," Garnett Mellen, 56, said, as she explained that claiming residency with her daughter in the new ZIP code had cut their premiums by more than half.
Charlottesville now claims the dubious distinction of having the highest individual-market health insurance costs in the country _ prompting families like the Mellens to look for extreme solutions.
An exodus of carriers, which was blamed on losses caused by the instability of the Obamacare marketplace, created a coverage vacuum, leaving locals and insurance regulators scrambling.
Only one carrier _ Virginia Beach-based Optima Health _ decided to continue to participate in the individual market, but it did so with monthly premium increases that were, on average, in the high double-digits and for some consumers as much as 300 percent, according to people interviewed for this story.
It's a problem that's likely to be replicated elsewhere, said Timothy Jost, an emeritus professor of law at Washington and Lee University in Virginia and expert on the health law.
"In many states, it's going to be hard to maintain a functional individual market," he said. "Charlottesville is sort of ahead of everybody else in this ... but this is the direction things are heading."
Insurers nationwide that intend to participate in the individual market face spring deadlines to file forms for 2019 plans and rate proposals. In Virginia, these dates are April 20 and May 4, respectively.
The situation in Charlottesville has left many residents at their wits' end about how to pay for their health insurance, prompting the evolution of an angry and rebellious civic movement and thrusting the costs of coverage into the center of local politics.
Charlottesville for Reasonable Health Insurance, a grass-roots organization and Facebook group of more than 700 people, has already claimed small victories in the state legislature, such as propelling the passage of a bill that will alleviate the cost burden for some of its members.
But its highest priority has been pressing state regulators to explain and possibly reconsider the decision that allowed for the stunning premium increase.
In the midst of various bureaucratic fits and starts, the state Bureau of Insurance (BOI) responded to the group April 11 by reiterating that Optima's rates were "actuarially justified." Ian Dixon, one of the group's organizers, said it plans to appeal this finding to the State Corporation Commission.
"We're not going away, that's for sure," said Dixon. "They're hoping they can wait us out. ... They would drag this out for a year if they could."
At the same time, the group has expanded its focus to other issues on health care costs, such as price transparency and regulatory reform.
