The Kansas Health Insurance Marketplace Enrollment Growth from 2014-2024

Financial Assistance

Under the ACA, individuals with annual income between 100 and 400 percent of the federal poverty level (FPL) may be eligible for Advance Premium Tax Credits (APTC) to help pay for premiums. Individuals with incomes between 100 and 250 percent FPL also may be eligible for Cost-Sharing Reduction (CSR) subsidies, which reduce out-of-pocket costs (deductibles, co-payments and coinsurance). The APTC can be used to subsidize the premiums of a bronze, silver or gold plan. CSR subsidies are only available for silver plans.

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The American Rescue Plan Act (ARPA), enacted in March 2021, extended APTC eligibility to people over 400 percent FPL and increased premium assistance for people already eligible for APTC under the ACA for two years (2021 and 2022). The Inflation Reduction Act (IRA), signed into law in August 2022, extended the enhanced tax credits through 2025.

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With enhanced tax credits, enrollees making between 100 and 150 percent FPL have no-cost premiums for a benchmark silver plan that pays 94 percent of health care costs on average. Enrollees making between 150 and 250 percent FPL are paying between 2.0 percent and 4.0 percent of their income in premiums. All income groups have a premium cap of 8.5 percent of income.

With the enhanced APTC, nearly all enrollees in the marketplace are subsidized. In 2024, 160,185 of the 171,376 (93.5 percent) enrollees received APTC and/or CSR in contrast to 73,579 of the 85,837 (85.7 percent) enrollees in 2020.

Consumer Assistance for the Kansas Marketplace

Under the ACA, the navigator program was designed to provide outreach, education and assistance for consumers enrolling in health insurance coverage through HealthCare.gov. Through grants awarded to nonprofit and provider organizations, navigators and assister programs help consumers to understand the coverage options available to them, find affordable coverage that meets their needs and provide the information, tools and resources to maintain their health coverage all year. Funded organizations operate as navigators year-round. Navigators are specifically required to provide assistance for underserved and historically marginalized populations.

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Kansas received $3.7 million in navigator funding in 2024, a dramatic increase from $213,317 in 2020 and the initial funding in 2013 of $886,085. This most recent funding is significantly higher than the amount Kansas received during the Trump and Obama administrations. Kansas navigator programs have received a total of $15.9 million in funding since the first open enrollment period, which was for plan year 2014.

Open Enrollment and Special Enrollment Periods

Open enrollment is the time period for enrolling in, reviewing or changing health insurance plans through the marketplace for the coming year. Typically, the open enrollment period (OEP) is 45 days long and runs from Nov. 1 through Dec. 15 for plans starting Jan. 1. The first OEP for plan year 2014 was more than six months long.

The COVID-19 public health emergency — declared on Jan. 31, 2020, and ending on May 11, 2023 — was a federal designation that provided additional resources to address the health and economic impacts of the pandemic. The COVID-19 Special Enrollment Period (SEP) extended the OEP to Aug. 15, 2021, allowing individuals without a qualifying life event to enroll in health coverage or reevaluate their existing health plan needs to take advantage of the increased APTC. The OEP was extended to 75 days for plan years 2022 through 2025.

Additional SEPs, outside of qualifying life events, include a low-income special enrollment period and an unwinding special enrollment period. From March 18, 2022, through Dec. 31, 2025, people who are eligible for APTC with expected income at or below 150 percent FPL can enroll or update an existing application throughout the year. The unwinding SEP is for qualifying individuals and their families who are losing Medicaid or Children’s Health Insurance Program (CHIP) coverage due to the end of the continuous enrollment associated with the COVID-19 public health emergency. The unwinding SEP from March 31, 2023, to Nov. 30, 2024, allowed enrollees to start coverage the first day of the month after they selected a plan.