Record 171,000 Kansans enroll in the federally subsidized ACA health insurance marketplace

Expiration of tax credits lowering premium costs likely to slash enrollment in 2026

BY: TIM CARPENTER

Kansas Reflector

TOPEKA — A record 171,000 Kansans enrolled this year in the subsidized health insurance marketplace under the Affordable Care Act, an increase more than 60,000 over the past two years.

The nonprofit, nonpartisan Kansas Health Institute reported Thursday that enrollment in Kansas for the 2024 plan year climbed 37.7% from the 124,000 total in 2023 and the 107,000 total in 2022. Nationally, enrollment in the ACA reached 21.5 million in 2024, a 31.1% rise from the previous year.

Twenty-two of Kansas' 105 counties had more than 7.1% of the population enrolled in health insurance through the federally assisted marketplace, while six counties in Kansas enrolled less than 4% of the population in the marketplace insurance system.

Enrollment growth was documented in southeast Kansas, including Allen County where 7.6% of the population this year took part in the subsidized insurance marketplace.

"We just try to meet people where they're at," said Rhonda Culp, director of Care Coordination at Thrive Allen County. "We just try to do any type of community outreach events within our communities that we are serving. Those could be from fairs to back-to-school efforts, promotions. We do billboards, radio and newspaper ads. We also do social media ads."

Enrollment in the Kansas marketplace — eight companies offered 98 plans during 2024, and every county had at least two insurance options — was again fueled by tax credits substantially cutting monthly premiums. All eligible plans must include 10 health benefits, including preventative health services. The plans must cover preexisting conditions.

Nine in 10, or 93.3%, of marketplace enrollees in Kansas took advantage of enhanced tax credits to lower premium payments in 2024. Overall, the average monthly premium paid by Kansans was $111, a $28 decrease compared to 2023.

Enhanced financial assistance through the American Rescue Plan and the Inflation Reduction Act was extended through the 2025 plan year, but those tax credits weren't made permanent. Without renewal of those special subsidies, enrollment in the Kansas marketplace in 2026 could return to 2021 levels and the number of Kansans without health insurance would rise.

Molly Gotobed, director at Community Health Council of Wyandotte County, said collaborative efforts at the state and county levels helped link eligible families in Wyandotte County to ACA health care. In 2024, KHI's report said, 7.4% of the county's population, or 13,000 people, secured health insurance through the marketplace.

She said outreach efforts including inserting marketplace information in utility bills sent to 77,000 residents of Wyandotte County. In addition, she said, managed care organizations contracted by the state to operate the state's Medicaid programs referred people who could be eligible for marketplace insurance.

"We worked with the Kansas chapter of the American Academy of Pediatrics to do some large events," Gotobed said.

KHI reported 201,000 Kansans applied for a marketplace health plan in the 2024 benefit year and 192,000 were declared eligible. In the end, 171,376 completed the enrollment process by selecting a plan or were automatically re-enrolled in a plan. One of four Kansas enrollees were new consumers of the marketplace.

Kansas enrollees receiving a tax credit on average paid $77 per month for health insurance premiums in 2024 compared to $97 in 2023. Enrollees without the tax credit, paid $578 per month during 2024 and $586 per month in 2023.

Here is the age breakdown of Kansas marketplace enrollees during 2024: age 0-17, 15,228 individuals or 8.9% of the total in that age group; age 18-25, 17,469, 10.2%; age 26-34, 27,528, 16.1%; age 35-44, 33,778, 19.7%; age 45-54, 32,111, 18.7%; age 55-64, 43,611, 25.4%; and age 65 and above, 1,641, 1%.

The federal Centers for Medicare and Medicaid Services issued a warning in May highlighting fraudulent ACA enrollment activity in 32 states, including Kansas. The Kansas Department of Insurance has identified 24 complaints pertaining to unauthorized enrollment activities by insurance agents tied to marketplace scams, the KHI report said.