Frequently asked questions about health insurance
coverage options in Kansas
Kansas uses the federally run exchange at Healthcare.gov, but with a marketplace plan management design that leaves plan oversight to the state. Kansas residents can enroll in an on-exchange health plan via HealthCare.gov or an approved enhanced direct enrollment entity.
Read more about the Kansas health insurance marketplace.
Although open enrollment for 2021 health plans ended in December 2020, a COVID/ARP-related enrollment window has been opened in 2021, and it continues through August 15. A qualifying life event is not necessary in order to use this enrollment window.
This window is an opportunity for uninsured Kansas residents to get coverage, for people with off-exchange or non-ACA-compliant plans to switch to an exchange plan, and for existing exchange enrollees to switch to a different plan in order to best take advantage of the additional premium subsidies created by the American Rescue Plan.
After August 15, a qualifying event will again be necessary in order to enroll in a plan for 2021 or make a change to an existing plan. Open enrollment (when qualifying events are not necessary) will start on November 1, 2021, for coverage effective January 1, 2022.
The Kansas exchange has five private insurers offering coverage for individuals and families:
- Blue Cross Blue Shield of Kansas
- Sunflower State Health Plan/Ambetter from Sunflower Health (Centene)
For 2021, overall average rate changes in the Kansas marketplace ranged from about an 8% decrease to a 10% increase.
Kansas marketplace enrollment climbed for 2021, with 88,627 people enrolling during the open enrollment period. And this is likely to increase further during the COVID-related enrollment period, thanks in large part to the extra premium subsidies that are available due to the American Rescue Plan.
During the first several weeks of the COVID/ARP enrollment window (but before the ARP’s new subsidies were available), nearly 5,000 Kansas residents enrolled in plans through the exchange. This was more than twice the number of people who enrolled during the same time period the year before (when a qualifying event would have been necessary in order to enroll).
According to US Census data, the uninsured rate in Kansas dropped from 12.3% in 2013 to 8.7% in 2016, and remained at that level in 2017. It grew slightly in 2018, to 8.8%, and again to 9.2% in 2019 (nationwide, there was an uptick in the uninsured rate under the Trump administration). The uninsured rate in Kansas in 2019 was equal to the national uninsured rate at that point, despite the fact that Kansas is among the minority of states that have not expanded Medicaid coverage.
As of early 2021 (before the American Rescue Plan made subsidies more widely available), there were 76,072 people in Kansas who were receiving premium subsidies in the health insurance marketplace to offset the cost of their individual health insurance premiums. More than 38,000 enrollees were also receiving cost-sharing subsidies to reduce their out-of-pocket costs, making it easier to afford the healthcare they need.
Including people who pay full price for their coverage, there were more than 88,000 people enrolled in individual market coverage through the Kansas exchange as of early 2021. All of these people have coverage for the ACA’s essential health benefits, with no lifetime or annual caps on their benefits.
Kansas is a Republican-controlled state, with voters favoring Donald Trump by a wide margin in the 2016 and 2020 elections. Republicans still hold a strong majority in the state’s legislature, but Democrat Laura Kelly became governor in 2019.
Kansas currently has just one Democrat in its Congressional delegation — Rep. Sharice Davids, who took office in 2019 and supports the ACA. The rest of the Congressional delegation from Kansas is opposed to the ACA.
Kansas joined the 2010 lawsuit challenging the constitutionality of the ACA (the Supreme Court ultimately upheld most of the law, but ruled that states could opt out of Medicaid expansion without losing the rest of their federal funding for Medicaid; Kansas has not expanded Medicaid). The state is also challenging the ACA in California v. Texas (Texas v. Azar), as one of the 18 plaintiff states seeking to overturn the entire ACA now that the individual mandate penalty has been eliminated.
Former Gov. Sam Brownback was a vocal critic of the ACA. Brownback considered a state-run marketplace early on, but soon turned against the idea. In August 2011, Brownback returned a federal loan earmarked for developing a state-run marketplace. Then-Insurance Commissioner Sandy Praeger, also a Republican, argued hard for Kansas to operate its own exchange, but was unable to convince Brownback or state legislators.
Medicaid is called KanCare in Kansas. Kansas is among the shrinking number of states that have not yet expanded Medicaid coverage under the ACA.
The state’s decision against Medicaid expansion leaves 45,000 Kansans in the coverage gap, meaning they neither qualify for Kansas Medicaid nor for tax subsidies to help purchase private coverage through the health insurance marketplace.
Former governors Sam Brownback and Jeff Colyer, both Republicans, were strongly opposed to Medicaid coverage expansion. But Governor Laura Kelly, a Democrat, took office in 2019 and identified Medicaid expansion as one of her top priorities. Medicaid expansion legislation passed the House in Kansas in 2019, but died in the Senate. Bipartisan legislation to expand Medicaid was again considered 2020, but the measure was ultimately unsuccessful, as was 2021 legislation. So Kansas continues to have a coverage gap and miss out on substantial federal funding that would be forthcoming if the state were to expand Medicaid.
Because Kansas has not expanded Medicaid, coverage is not available for low-income adults without children unless they’re elderly or disabled. Coverage is only available for the traditionally eligible groups with low incomes, including children, pregnant women, families with minor children, the elderly, and disabled residents. And adults with dependent children are eligible only if their household income is under 33% of the federal poverty level.
Read more about Medicaid expansion in Kansas.
Kansas law limits short-term health insurance plans to initial terms of not more than twelve months (ie, the same as the federal rules that took effect in late 2018). But the state only allows short-term insurance plans to renew one time, so the maximum duration is two years.
So the three-year maximum duration allowed under federal rules does not apply in Kansas. But legislation is under consideration in 2021 that would remove the state’s one-renewal limit for short-term plans. As of April 2021, it had passed easily in the Senate, and had been sent to a House committee.
Read more about short-term health insurance in Kansas.
As of February 2021, there were 548,639 Medicare beneficiaries in Kansas. Most Medicare enrollees in Kansas opt for Original Medicare, with only about a quarter enrolled in private Medicare Advantage plans instead. There are 62 insurers that provide Medigap plans in Kansas, and the state requires Medigap insurers to make coverage available to disabled Medicare beneficiaries under 65.
Read more about Medicare in Kansas.
- Kansas Insurance Department, overview of health insurance
- Senior Health Insurance Counseling for Kansas (SHICK) – Assistance for Medicare beneficiaries
- Medicare Rights Center – a nationwide service that can provide assistance and information to people with Medicare
- Kansas Department of Health, KanCare & Medicaid – a wide range of resources related to health coverage for low-income Kansans
- KanCare managed care plans (the insurer listed on your KanCare ID card is your managed care provider)
In April 2016, Kansas enacted HB2454, legislation that allows health insurers to offer EPO plans with narrow networks and “gatekeeper” requirements similar to HMOs.
HB2066, which would have expanded Medicaid coverage in Kansas, passed the House in 2019 but stalled in the Senate. Similar legislation (SB252 and SB246) also failed in the 2020 session, and again in the 2021 session (an amendment to SB238)
Prior to 2014, when the ACA reformed the individual health insurance market, private coverage was medically underwritten in nearly every state, including Kansas. People with pre-existing conditions (who were not employed by a business that offered group health insurance benefits) often found themselves unable to purchase coverage, or only able to get policies that excluded their pre-existing conditions.
The Kansas Health Insurance Association (KHIA) was created in 1993 to provide a coverage option for applicants who were not eligible for plans in the private market because of medical history.
Because of the ACA’s guaranteed-issue provision, medical history is no longer a factor in eligibility for private plans in the individual market. This means that high-risk pools are no longer needed the way they were prior to 2014. KHIA ceased operations on January 1, 2014, and was successfully terminated in mid-2015 following significant communication with members about transitioning to the private market.