Rising health insurance costs hit Kansans amid Congressional battle over subsidies

A study released Thursday by the Kansas Insurance Department found that most of the insurance companies serving Affordable Care Act customers on the marketplace expect to see costs rise by 11% to 34% on average. (Photo by Morgan Chilson/Kansas Reflector)

TOPEKA — Kansans purchasing health insurance on the Affordable Care Act marketplace are likely to see their premiums increase in 2026, some by as much as 34%, and that’s without calculating the additional dollars they will pay if subsidies aren’t reinstated by Congress. 

ACA marketplace open enrollment starts Saturday for 2026 insurance plans, and Kansans are concerned about what to expect after seeing national estimates that health insurance rates may double. 

Health insurance rates are going up across the board, and many factors contribute to that, including use, cost of care and advances in types of care, increased prescription costs and renegotiated provider reimbursement contracts, said Kyle Strathman, deputy chief of staff at the Kansas Department of Insurance. 

On the marketplace, Kansans also are being hit with the expiration of 2026 marketplace subsidies, said Maci Mishler, owner of Rural Health Advisors, a health insurance agency in Ness City and with an office in Nebraska. 

“I’m really concerned that people in the marketplace have their heads buried in the sand and they’re not realizing what’s about to happen,” she said, adding that she’s getting more calls from clients about Medicare rates than from those who buy marketplace insurance. 

 

Kansas ACA

Of the seven companies offering ACA coverage in Kansas, one is new to the market and has no previous rates to compare. Another, Blue Cross and Blue Shield of Kansas City, showed an average rate decrease of 6.14%, according to the Kansas Department of Insurance’s 2026 overview of the health insurance market, released Thursday. 

The remaining five reported the following average rate increases among 2026 marketplace plans:

• 11.74% – UnitedHealthcare Insurance Co.
• 14.44% – Oscar Insurance Co.
• 16.65% – Blue Cross and Blue Shield of Kansas Inc.
• 30.76% – Medica Insurance Co.
• 33.66% – Ambetter from Sunflower Health Plan insured by Celtic Insurance Co.

The four companies offering small business insurance plans through ACA reported that rates will increase, on average, from 8.4% to nearly 10%, the study found. 

The insurance market study also said the numbers of Kansans using the marketplace have steadily increased, topping 200,000 in 2025, up from 171,000 in 2024. In 2017, 98,780 people were enrolled. 

Strathman said it’s challenging to predict how the insurance market will be affected. National experts expect many people who see significant cost increases to go without insurance. 

“It is difficult to project as we do not know if people will leave the ACA for other options such as short-term limited duration plans or group plans, but projections of enrollment to the individual ACA plans are expected to decrease significantly,” he said. 

A decrease would negatively affect the market, as insurance companies depend on the number of people enrolled to decrease risk, Mishler said. 

Cindy Samuelson, spokeswoman for the Kansas Hospital Association, said any decrease in the number of Kansans who have health insurance is concerning. 

“When they’re uninsured, that’s not good for their health care because they don’t get proactive health care,” she said. “It also means when they have urgent care, they’re going to come to the emergency room, and they’re uncompensated, so they have no insurance.”

When hospitals face rising uncompensated care costs, those challenges begin to affect the entire medical system. Kansas has the highest number of rural hospitals at immediate risk of closing of any state, at 25 hospitals, according to the March 2025 report from the Center for Healthcare Quality and Payment Reform.

 

Hitting Kansans’ budgets

Kansan Laura Mead is self-employed, and she’s nervous about what to expect from her marketplace plan when she sees rates on Saturday — that’s even after an initial exploration showed her annual health insurance cost may decrease. 

At age 60, she currently pays about $1,100 a month for health care through ACA, which she says has an actual premium of $1,427 a month. The additional $327 is covered by the ACA subsidies, which are ending unless Congress takes action. 

“For the first time in my adult life, I’m facing a real serious prospect of not having health care,” she said.

After researching, Mead said she expects that her insurance costs may double, which would leave her paying an unsustainable $2,000 each month. 

Mead is considering a catastrophic policy, which would cover her if a significant health problem occurred. She’s frustrated at how difficult it is to weigh her options. The ACA marketplace can be confusing, she said, and she’s finding that even Kansas U.S. legislators don’t understand what’s happening. 

She called one representative’s office and the staff person told her that “we’re trying to get people who aren’t working off those programs,” Mead said. 

Carolyn McKee, a small business owner in Holton, posted on Facebook Friday that she received a letter saying her private Blue Cross and Blue Shield plan would increase by $700 a month. Within an hour, her post had more than 40 comments, with some complaining they were also seeing their rates double. 

Many self-employed individuals like McKee and Mead, including an estimated 27% of farmers, get their health insurance through the marketplace. 

 

More than subsidies

Mischler said people need to also be aware of the “cliff” that’s part of ACA marketplace rules, as that will also affect many Kansans. 

“Pre-Covid, if you had income over 400% of the federal poverty level, you weren’t going to qualify for a subsidy at all,” she said. “Then during Covid, they expanded subsidies and even people who made a ton of money could qualify for some subsidies.”

Mischler said consumers have gotten used to paying those reduced rates for health insurance and that 400% requirement is now going back in place. 

“That’s going to hit hard, right now especially,” she said. “Even if we estimate their income as under that 400%, if they make one penny over that 400%, then they’re going to pay back all the subsidy that they’ve received at tax time.”

With farmers and others who are self-employed, it can be difficult to estimate income, and Mischler said she’s concerned about people needing to repay thousands of dollars in subsidies. 

 

Political chaos

The government shutdown is tied to the ACA marketplace subsidies, with Democrats saying they won’t support a spending bill until Republicans agree to continue marketplace subsidies set to expire at the end of the year. 

Republicans maintain the Democrats are fighting to keep undocumented immigrants on ACA marketplace insurance. The right-wing group Public Policy Solutions posted on Twitter — and Kansas Speaker of the House Dan Hawkins reposted — that “Democrats chose to shut down the government to fund healthcare for illegal immigrants and keep pandemic-era ObamaCare subsidies flowing to insurance giants.”

Anyone who isn’t in the country legally is not eligible for marketplace insurance.

Gov. Laura Kelly, during a press conference Friday in her role as chairwoman of the Democratic Governors Association, called on Congress to return to session and reinstate ACA subsidies, as well as address Supplemental Nutrition Assistance Program benefits that are delayed because of the federal shutdown. 

“We’re here today because our country is at a dire inflection point starting tomorrow,” she said. “Twenty-two million Americans will wake up to see their health care premiums increase by an average of 75%, and 42 million people will lose SNAP benefits and go hungry because DC Republicans sold them out at the behest of Donald Trump.”

Rural communities will be hit the hardest, she said, noting that “dozens” of rural health clinics nationwide have shut down. She also said that Freeman Health System’s plans in Kansas to build a new hospital in Frontenac have been dropped. 

In a statement three weeks ago, Freeman said conditions weren’t feasible to open the hospital at this time, pointing to changes in the One, Big Beautiful Bill Act.