Key points
- In 2024, eight insurance companies offer 98 health insurance plans in the Kansas marketplace.
- The average monthly premium for a basic silver plan in Kansas for a family of four in 2024 before the application of Advance Premium Tax Credits increased by 3.5%, less than the 4.0% increase statewide.
- In 2024, the benchmark silver plan deductibles will range from $2,500 to $8,395 for an individual and $7,000 to $16,790 for a family of four.
- Under the Inflation Relief Act, which extends the expanded premium tax credits in the American Recovery and Reinvestment Act, consumers with incomes between 100 and 150 percent of the federal poverty level can qualify for a free or nearly free plan if they enroll in a benchmark silver plan.
Introduction
The eleventh annual open enrollment period (OEP) for the Kansas health insurance marketplace, created under the Affordable Care Act (ACA) and administered by the federal government through Healthcare.gov, began November 1, 2023 and ends January 16, 2024. In 2024, coverage for individuals enrolling before December 15 will take effect on January 1, 2024. Coverage for individuals enrolling after December 15 but before January 16 will take effect on February 1, 2024.
In 2024, the Inflation Reduction Act of 2022 continues to allow 2024 enrollees to take advantage of the enhanced Advanced Premium Tax Credit (APTC) benefits that became available in 2022 under the American Recovery and Reinvestment Act (ARPA) of 2021. The Inflation Reduction Act extends the temporary ARPA enhancements through 2025.
This fact sheet provides information on plan options offered for 2024, health insurance costs, financial assistance options, and enrollment factors.
Plan options
In 2024, eight insurance companies offer 98 health plans in the Kansas market ( Figure 1 ) - down from 128 plans available from eight insurance companies in 2023. These companies include Blue Cross and Blue Shield of Kansas, Inc. (103 counties); Ambetter of Sunflower Health Plan, insured by Celtic Insurance Company (91 counties); UnitedHealth Care Insurance Company (84 counties); Medica Insurance Company (42 counties); Aetna Life Insurance Company (19 counties); Oscar Insurance Company (16 counties); US Health and Life Insurance Company (4 counties); and Blue Cross and Blue Shield of Kansas City (2 counties).
The decrease in the number of health plans available in the Kansas market in 2024 is due in part to Cigna Health and Life Insurance Company, which offered 25 plans in eight counties in 2023, deciding not to offer plans in Kansas in 2024. Aetna Life Insurance Company, which recently entered the Kansas market in 2024, offers only nine plans in 19 counties.
All eight insurers offer enhanced bronze, silver and gold plans. One insurer offers a bronze plan, and three insurers also offer catastrophic plans. This is the seventh consecutive year the Kansas marketplace has not offered platinum plans. As in 2023, all Kansas counties have at least two insurers offering coverage, and all plans offered are Exclusive Provider Organization (EPO) plans, which only cover services provided in a "narrow network" of providers, except in emergencies.
Under the ACA, dental coverage is an essential health benefit for children enrolled in an ACA-compliant health insurance plan and is included in the cost of the premium, but not for adults.
Some insurers offer policies with medical and dental coverage for adults, meaning the premium covers both medical and dental policies and APTC can be applied to it.
In addition, adults may purchase a separate dental plan, but they must also be enrolled in an ACA-compliant health plan and will be responsible for two separate premiums. APTC cannot be applied to premiums for a separate dental plan. For 2024, a total of 15 stand-alone dental plans are offered from five insurers.
Health insurance expenses
A consumer's cost of health care depends on their monthly premiums and the cost of deductibles, co-payments, co-insurance, and non-covered services.
Premiums in the Kansas marketplace have increased in 2024. The average premium for a benchmark silver plan in Kansas for a family of four is 3.5 percent higher than in 2023. The average premium increase for a benchmark silver plan in Kansas for a family of four was lower than the 4.0 percent increase nationally. Figure 2 shows the average monthly premiums for all Kansas counties under the benchmark silver plan.
As shown in Figure 3 , monthly premiums vary significantly across counties. For example, in Rating Area 7, the difference in premiums for a benchmark silver plan for a couple age 60 is about $360, while premiums can be as high as $2,410 per month for a couple age 60 before APTC applies. Premiums vary depending on regional factors such as cost of care, cost of living, and the number and type of providers available. Premiums also vary depending on the specific characteristics of the covered person, including age, residence, smoking and number of people in the household. Higher rates cannot be charged based on gender or for people with pre-existing conditions.
In addition to the monthly premium, consumers incur certain out-of-pocket costs, including deductibles, co-payments, and co-insurance when they use services. Except for certain preventive and other services covered by the plan, consumers must first pay a deductible amount for covered services before the plan will start paying for them. Co-payments or co-insurance are generally required after the deductible is met. The deductible for a benchmark silver plan ranges from $2,500 to $8,395 for an individual and $7,000 to $16,790 for a family in 2024.In nearly half of the counties (51 counties), the deductible for an individual on a benchmark silver plan is $5,900. For a family plan, the deductible amount is typically double.
ACA marketplace plans are also required to specify a maximum copayment amount, which is the maximum amount a consumer can pay for covered services during the plan year. This maximum amount depends on the consumer's income. However, regardless of income (if you qualify for coverage in the marketplace), the maximum amount a consumer can pay for covered services is up to $9,450 for an individual or up to $18,900 for a family of four.
Financial assistance
The ACA provided financial assistance to marketplace participants with certain income levels to help pay for monthly premiums and additional costs. Before ARPA and the Inflation Reduction Act, consumers with incomes between 100 and 400 percent of the federal poverty level (FPL) ($26,500 to $106,000 for a family of four in 2021) were eligible for APTC and spent between 2.0 and 9.83 percent of their income on premiums.
Under ARPA and now the Inflation Reduction Act, in 2024, consumers with incomes between 100 and 400 percent FPL ($30,000 to $120,000 for a family of four in 2023) will spend between 0 and 8.5 percent of their income on premiums for a basic silver plan. Households with incomes above 400 percent FPL are also eligible for APTC, which caps their premiums for a basic silver plan at 8.5 percent of their income. Consumers with incomes between 100 and 150 percent FPL ($30,000 to $45,000 for a family of four in 2023) may qualify for a free or nearly free plan on the marketplace. People with incomes less than 100 percent FPL are generally not eligible for financial assistance in the marketplace. These enhanced marketplace subsidies were set to expire at the end of 2022, but the Inflation Reduction Act extended them through the end of 2025.
APTCs are calculated based on the cost of a benchmark silver plan, but can be used to purchase any plan available in the marketplace, regardless of metal level. APTC cannot be used to purchase a catastrophic insurance plan. When using APTC, consumers may find it more advantageous to purchase a gold plan with more benefits and a lower deductible. For example, the least expensive gold plan in Sedgwick County may have a monthly premium of $400 before APTC (or $142 after APTC) and a $750 deductible for a person with a household income of 250 percent FPL. By comparison, the same person could purchase the least expensive silver plan with a lower monthly premium of $379 before APTC (or $121 after APTC) but a higher deductible of $5,900. Examples of premium reductions due to APTC in 2024 are shown in Figure 4 .
Under the ACA, the rules for cost-sharing reduction (CSR) subsidies remain the same. Consumers with incomes between 100 and 250 percent FPL ($30,000 to $75,000 for a family of four in 2023) who are enrolled in silver plans are still eligible for CSR subsidies to reduce their out-of-pocket costs. CSR subsidies are not available in other tier plans. For example, for a Sedgwick County resident with income between 151 and 200 percent FPL, the deductible could be reduced to $1,600 or less with co-payments/coinsurance for a benchmark silver plan. The deductible will be reduced to $550 or less with co-payments/coinsurance for a benchmark silver plan for a Sedgwick County resident with income between 100 and 150 percent FPL.
Factors affecting enrollment in the ACA marketplace
Several factors could affect enrollment in 2024.
- Continuation of the expanded APTCs provided in ARPA and the Inflation Reduction Act through 2025.
- Special enrollment period for individuals who lose Medicaid or CHIP coverage between March 31, 2023 and July 31, 2024 due to the cancellation of continuous coverage provided during a COVID-19 health emergency.
- A special enrollment period through 2024 for consumers with family income up to 150 percent FPL ($21,870 for an individual and $45,000 for a family of four) who qualify for the APTC. In Kansas, most people with incomes below 100 percent FPL are not eligible for marketplace tax credits.
- The percentage that determines the affordability of employer-sponsored health insurance under the ACA is 8.39%, down from 9.12% in 2023 and an initial 9.61% in 2022. This decrease in the affordability percentage may increase the number of people eligible for APTC if they enroll in a health plan on the Marketplace.