Health and Human Services (HHS) reported that 75,836 Kansans had selected health plans as of Jan. 9. During 2014 open enrollment, about 57,000 Kansas enrolled in private coverage.
An earlier HHS report that looked at the first month of 2015 open enrollment showed that 80 percent of Kansas residents who selected a plan qualify for tax credits to help pay for coverage.
Open enrollment continues through Feb. 15. Coverage purchased between Jan. 16 and Feb. 15 will be effective March 1. After Feb. 15, only consumers who experience a qualifying event, such as getting married, will be able to sign up for insurance.
Penalties for not having insurance are bigger this year: 2 percent of annual income or $325 per adult, whichever is greater. See the healthinsurance.org penalty calculator to see if and how much you may have to pay.
Five insurers participating in 2015 exchange
Blue Cross and Blue Shield of Kansas Solutions, an HMO and a subsidiary of Blue Cross Blue Shield of Kansas, joined the 2015 marketplace. The new entrants joins four other insurance companies that participated in the exchange in 2014: Blue Cross and Blue Shield of Kansas, Blue Cross of Kansas City, Coventry Life and Health, and Coventry Health Care of Kansas.
How much does insurance cost in 2015?
2015 premiums on the Kansas marketplace are up just 4 percent from 2014 rates, according to a comprehensive study completed by The Commonwealth Fund. Nationally, rates are flat. However, the 0 percent average increase masks 10+ percent increases in 10 states and 10+ percent decreases in 14 states.
Below average enrollment in 2014
During the first open enrollment period, 57,013 Kansans enrolled in qualified health plans and nearly 14,000 people qualified for either Medicaid or the Children’s Health Insurance Program (CHIP) under existing eligibility criteria according to the Kaiser Family Foundation. In all, about one in five of those Kansans eligible signed up for private insurance — lower than the national average of 28 percent.
Among Kansas residents selecting a QHP, 85 percent qualified for financial assistance. Nineteen percent of Kansans selected a bronze plan (20 percent nationally), 60 percent selected a silver plan (65 percent nationally), 16 percent selected a gold plan (9 percent nationally), 2 percent selected a platinum plan (5 percent nationally) and 4 percent selected a catastrophic plan (2 percent nationally). Thirty-one percent of Kansas enrollees were between the ages of 18 and 34.
You may have heard that Kansas actually saw its uninsured rate increase from 2013 to 2014 according to a widely publicized Gallup survey. The validity of the Kansas results have been questioned by both Gallup and Kansas insurance experts, and the survey error range for lower population states was plus/minus 5 points.
Health care reform: Looking ahead
Medicaid expansion will likely be the focus of health care reform efforts in Kansas in 2015.
Kansas decided against expanding its Medicaid program, which is called KanCare, despite a December 2013 poll that found 72 percent of registered Kansans voters favored expansion. While other Republican governors proceeded with Medicaid expansion, Brownback remained opposed — as did the state’s Republican-controlled Legislature, which didn’t act on Medicaid expansion in 2014.
The Kansas Hospital Association continues to advocate for expansion, touting a “Kansas solution” that includes cost-sharing provisions, high deductible plans, health savings accounts (HSAs) and other provisions that have been proposed or implemented in other conservative states.
Hospital officials are testifying during state legislative committee meetings to explain the financial toll of the state’s decision against Medicaid expansion. Rural hospitals in particular are struggling because the Affordable Care Act is partly funded through a reduction in hospital payments from Medicare. In states that expanded Medicaid, the Medicare reduction is offset by the increased number of people who are insured (either through private coverage sold on the marketplace or Medicaid). In states that don’t expand Medicaid, the uninsured rate remains higher and hospitals continue to struggle with higher levels of uncompensated (charity) care.
A recent Urban Institute report shows Kansas missing out on $5.3 billion in federal funding and hospitals losing $2.6 billion in Medicaid reimbursement.
How Kansas approached marketplace implementation
Kansas opted to use HealthCare.gov rather than implement a state-run marketplace. The decision against a Kansas-run exchange came despite the efforts of Insurance Commissioner Sandy Praeger and some initial support from Gov. Sam Brownback. Brownback, while critical of the Affordable Care Act, initially supported Praeger’s exchange planning efforts.
However, Brownback grew less and less supportive over time. In August 2011, Brownback returned a federal grant intended to help the state develop technical infrastructure for running the exchange. The return of the grant effectively quashed a state-run exchange, so Praeger began recommending state-federal partnership as a way for the state to retain some control.
In November 2012, Brownback announced that the state would default to a federally operated exchange, issuing a statement that said in part, “My administration will not partner with the federal government to create a state-federal partnership insurance exchange because we will not benefit from it and implementing it could costs Kansas taxpayers millions of dollars.”
During the 2014 legislative session, Kansas lawmakers debated a bill (SB 362) that would have subjected anyone who wanted to serve as a navigator to requirements above and beyond those at the federal level. Kansas navigators would have been subjected to criminal background checks, been fingerprinted, required to disclose their credit histories, and charged an annual $100 registration fee. The bill would have also prohibited navigators from recommending a specific insurance policy for a consumer. The bill passed the Senate, but failed to clear a House committee.
Kansas health insurance exchange links
State Exchange Profile: Kansas
The Henry J. Kaiser Family Foundation overview of Kansas’ progress toward creating a state health insurance exchange.
Kansas Insurance Department, Consumer Assistance Division
Assists consumers who have purchased insurance on the individual market or who have insurance through an employer who only does business in Kansas.
(800) 432-2484 / Local: (785) 296-7829