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.
For Kansans who buy their own individual/family health insurance, the open enrollment window runs from November 1 through January 15.
Outside of the open enrollment period, Kansas residents will need a qualifying event in order to enroll in coverage or make a plan change.
Learn more about your enrollment opportunities in our comprehensive guides:
In Kansas, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). More than 90% of consumers who enrolled in 2022 coverage through HealthCare.gov received premium subsidies.
Kansans may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in Kansas.
For people who aren’t eligible for Medicare, Medicaid, or subsidies in the Kansas marketplace, short-term health insurance is also a lower-cost coverage option, albeit without the consumer protections that apply to other types of health coverage. In Kansas, several insurers offer short-term plans.
The Kansas exchange has eight private insurers offering 2023 coverage for individuals and families, which is a record high for the state’s exchange:
- Medica
- Blue Cross Blue Shield of Kansas
- Blue KC (Blue Cross Blue Shield of Kansas City)
- Oscar
- Cigna
- US Health & Life Insurance Company
- Ambetter from Sunflower Health Plan/Celtic
- UnitedHealthcare (new for 2023, after previously offering coverage in 2016)
For 2023, overall average rate changes in the Kansas marketplace range from a decrease of almost 1% to an increase of about 18%.
According to US Census data, the uninsured rate in Kansas was 12.3% in 2013 and stood at 9.2% in 2019. 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 2022, there were 107,784 people who had signed up for coverage through the Kansas exchange/marketplace, and more than 97,000 of them were receiving premium subsidies in the health insurance marketplace to offset the cost of their individual health insurance premiums. And nearly 50,000 Kansas enrollees were also receiving cost-sharing subsidies to reduce their out-of-pocket costs, making it easier to afford the healthcare they need.
Everyone who enrolled in coverage through the exchange — including those who pay full price — has 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 also challenged the ACA in California v. Texas (Texas v. Azar), as one of the 18 plaintiff states that sought to overturn the entire ACA after the individual mandate penalty was eliminated (the Supreme Court ultimately upheld the ACA in that case).
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 low-income 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. 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. 2022 legislation did not advance out of committee, and 2023 legislation was still in committee as of March 2023. 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 38% of the federal poverty level (33% plus a built-in 5% income disregard).
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.
The Kansas legislature passed bills in 2021 (SB29) and 2022 (SB199) to remove the state’s one-renewal limit for short-term plans, but both bills were vetoed by Gov. Kelly and the legislature did not have enough votes to override the vetoes. So the three-year maximum duration allowed under federal rules does not apply in Kansas.
Read more about short-term health insurance in Kansas.
As of November 2o22, there were 568,770 Medicare beneficiaries in Kansas. Most Medicare enrollees in Kansas opt for Original Medicare, with only about 29% enrolled in private Medicare Advantage plans instead. Kansas 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.
The Kansas legislature passed a bill (SB199) in 2022 to allow short-term health plans to renew for a total duration of up to 36 months, but the measure was vetoed by Gov. Laura Kelly.
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) and the 2022 session (HB2675).
Medicaid expansion legislation (H.B.2415 and S.B.225) is again under consideration in Kansas as of 2023.
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.
