Kansas Health Insurance

 

Health insurance in Kansas

● Kansas uses the federally managed health insurance marketplace, with enrollment through HealthCare.gov.

● The open enrollment period for 2021 health insurance plans runs from November 1 to December 15, 2020. Owners with qualifying events can still sign up or make changes to their coverage for 2020.

● Short-term health insurance plans can be sold in Kansas with initial plan terms of up to 12 months.

● Five insurers offer 2020 coverage through the Kansas health insurance marketplace, all five will continue to offer plans for 2021.

● Nearly 86,000 Kansas residents enrolled in 2020 medical insurance coverage through the state exchange.

● Kansas has not implemented medical coverage expansion, but it is a top priority for Governor Kelly and Democrats in the legislature.

● Kansas has below-average enrollment in Medicare Advantage, above the average enrollment in autonomous Part D plans.

● The high-risk pool in Kansas was closed after the ACA allowed people to purchase individual marketplace coverage regardless of their medical history.

This page is dedicated to helping consumers quickly find health insurance resources in the state of Kansas. Here you will find information about the many types of health insurance coverage available. You can find the basics of the Kansas health insurance marketplace and the next open enrollment period; a brief overview of Medicaid expansion in Kansas; a quick look at the availability of short-term health insurance in the state; statistics on state-specific Medicare rules; as well as a collection of health insurance resources for Kansas residents.

Kansas Health Insurance marketplace

When it comes to the Affordable Care Act, Kansas has maintained a position of reluctance. Sunflower State is part of a declining minority of states that haven't expanded Medicaid coverage Under the Affordable Care Act, it defaults on the federally managed health insurance marketplace , though with a marketplace plan management model for the exchange.

85,837 people enrolled in private health insurance plans through the Kansas marketplace during the open enrollment period for 2020 coverage. Enrollment peaked in the Kansas marketplace in 2016, when more than 101,000 people purchased coverage.

The Kansas stock exchange has five private insurers that offer coverage for individuals and families:

● Medical

● Blue Cross Blue Shield of Kansas

● Sunflower Health Plan/ Ambetter from Sunflower Health (Centene)

● Oscar

● Cigna

All five will continue to offer health insurance plans in the Kansas marketplace for 2021, with overall average rate changes ranging from a decrease of about 8% to a 10% increase.

Kansas open enrollment period and dates

Open enrollment in Kansas for 2021 health plans runs from November 1, 2020 to December 15, 2020. This applies to the individual marketplace plan that people buy for themselves (as opposed to coverage provided to people who are employed by companies that offer group health insurance).

During the enrollment period from November 1 to December 15, Kansas residents can sign up for individual marketplace coverage for the first time or switch to a different plan for 2021. Outside of that window, residents can sign up or make changes to their coverage only if they experience a qualifying event.

Medicaid expansion in Kansas

Medicaid is called KanCare in Kansas. Kansas is among the declining number of states that have not yet expanded Medicaid coverage under the ACA.

The state's decision against Medicaid expansion leaves 40,000 Kansans in the coverage gap, meaning they qualify neither for Kansas Medicaid nor for tax subsidies to help buy private coverage through the health insurance marketplace.

Former governors Sam Brownback and Jeff Colyer, both Republicans, were strongly opposed to expanding Medicaid coverage. But Governor Laura Kelly, a Democrat, took a fight in 2019 and identified Medicaid expansion as one of her top priorities. The Medicaid expansion bill passed the House in Kansas in 2019, but died in the Senate. Bipartisan legislation to expand Medicaid was again considered 2020, but the measure ultimately was unsuccessful. So Kansas continues to have a coverage gap and lose substantial federal funding that would be available if the state expanded Medicaid.

Because Kansas has not expanded Medicaid, coverage is not available to low-income adults without children unless they are elderly or disabled. Coverage is only available to traditionally eligible low-income groups, including children, pregnant women, families with minor children, the elderly, and disabled residents. And adults with dependent children are entitled only if their family income is less than 33% of the federal poverty level.

Short-term health insurance in Kansas

Kansas law limits short-term health insurance plans to initial terms of no more than twelve months (that is, the same as federal rules that are 2018). But the state only allows short-term insurance plans to renew once, so the maximum duration is two years. So the maximum duration of three years allowed by federal rules does not apply in Kansas.

How did Obamacare help Kansas?

According to U.S. Census data, the uninsured rate in Kansas fell 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%, although it was still slightly below the national average, although Kansas did not expand Medicaid coverage (nationally, there was an uninsured rate increase under the Trump administration).

As of early 2020, there were 71,167 people in Kansas receiving premium subsidies in the health insurance marketplace to offset the cost of their individual health insurance premiums. More than 33,000 enrollees also received cost-sharing subsidies to reduce their out-of-pocket costs, making it easier to afford the health care they needed.

Including people who paid the full price for their coverage, there were nearly 80,000 people with individual marketplace coverage made through the Kansas exchange in 2020. All of these people have coverage for the ACA's essential health benefits, with no annual or lifetime ceilings on their benefits.

Kansas and the Affordable Care Act

Kansas is a Republican-controlled state, with voters favoring Donald Trump by a wide margin in the 2016 election. Republicans still hold a strong majority in the state legislature, but Democrat Laura Kelly became governor in 2019.

Kansas currently has only one Democrat in its congressional delegation: Representative Sharice David's, who took office in 2019 and supports the ACA. The rest of the Kansas congressional delegation is opposed to the ACA.

Kansas joined the 2010 lawsuit challenging the ACA's constitutionality (the Supreme Court ultimately upheld most of the law, but ruled that states could forgo 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 against Texas (Texas vs. Azar), as one of 18 plaintiffs seeking to overturn the entire ACA now that the individual warrant sanction has been eliminated.

Former Governor Sam Brownback was a vocal critic of the ACA. Brownback considered a state-run marketplace at first, but soon turned to the idea. In August 2011, Brownback repaid a federal loan for the development of a state-run marketplace. Then-Insurance Commissioner Sandy Praeger, also a Republican, strongly argued that Kansas handled its own exchange, but was unable to convince Brownback or state lawmakers.

Kansas' high-risk insurance pool

Before 2014, when the ACA reformed the individual health insurance marketplace, private coverage was underwritten by the medical reference point in nearly every state, including Kansas. People with pre-existing conditions (who were not employed by a company offering group health insurance benefits) were often unable to purchase coverage or were only able to obtain 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 marketplace because of medical history.

Due to the guaranteed issue of the ACA, medical history is no longer a factor in eligibility for private plans in the individual marketplace. This means that high-risk pools are no longer needed as before 2014. KHIA ceased operations on 1 January 2014 and was successfully terminated in mid-2015 following significant communication with members on the transition to the private marketplace.

Medicare coverage and enrollment in Kansas

As of July 2020, there were 544,530 Medicare beneficiaries in Kansas. Most Medicare enrollees in Kansas opt for Original Medicare, with only about 21% enrolled in private Medicare Advantage plans. 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 the age of 65.

Kansas Health Insurance Resources

● Kansas Insurance Department, health insurance overview

● Senior Health Insurance Counseling for Kansas (SHICK) – Assisting Medicare beneficiaries

● Medicare Rights Center - a national service that can provide assistance and information to people with Medicare

● Kansas Department of Health, KanCare & Medicaid - a wide range of health coverage resources for low-income Kansan

● KanCare managed service plans (the insurer listed on your KanCare ID card is your managed service provider)

Health care reform legislation in Kansas

In April 2016, Kansas enacted HB2454, legislation that allows health insurers to offer EPO plans with tight networks and HMO-like "gatekeeper" requirements.

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.