The Affordable Care Act, more commonly known as Obamacare, has had a substantial effect on Kansas health insurance. It created healthcare marketplaces where individuals and small businesses can purchase coverage; prohibited discrimination against those with preexisting conditions; and required most Americans to have health coverage or face penalties.
Kansans who enroll during open enrollment can choose among private marketplace plans with various levels of coverage and costs, such as Silver, Bronze and Catastrophic plans.
Health Insurance Exchanges
Under the Affordable Care Act, health insurance coverage for consumers will be made available through state exchanges. Kansas will use a federally facilitated health insurance exchange that allows people to compare plans and select one best suited to their needs based on comparison tools provided on this exchange platform. It offers options suitable for individuals, families, and small businesses alike based on income; some consumers may even qualify for premium tax credits and cost-sharing reductions depending on eligibility criteria.
Insurance agents and brokers provide assistance for consumers selecting and enrolling in plans through health insurance exchanges. However, these professionals must adhere to state and federal guidelines on how best to assist consumers.
Health insurance marketplace is divided into tiers, such as Bronze, Silver, Gold and Platinum plans being provided. Each plan offers different levels of coverage; with higher-tier plans providing more of your medical costs covered than lower tier plans. Bronze and Silver policies usually have lower premiums while Gold policies usually come with higher ones; Kansas provides several resources that can assist residents in selecting their ideal policy plan.
Premium Tax Credits
The Affordable Care Act offers assistance in paying for marketplace health plans through premium tax credits and cost-sharing reductions, both of which are only available through an insurance exchange and can benefit individuals, families and small businesses alike.
Most Kansas residents obtain private health insurance through their employer; those without access can purchase individual health plans in the marketplace; these plans typically cover anywhere between 60% to 80% of medical expenses depending on which plan is chosen.
The federal government uses an income estimate to calculate your premium tax credit. You can either check it online, or visit an approved insurance broker such as eHealth to have your actual income verified. During Open Enrollment season (November 1st- December 15th), enroll or renew marketplace plans during Open Enrollment period.
Cost-sharing reductions are a separate subsidy designed to lower deductibles, copays and coinsurance payments associated with using services covered by their health plan. Some individuals who receive premium tax credits also qualify for cost-sharing reductions.
Cost Sharing Reductions are available to individuals whose income falls between 250% of poverty line and 300%. They modify the actuarial value of silver plans in order to lower deductibles, copays and out-of-pocket maximums; these are known as CSR 94 plans.
CSRs were reimbursed by the federal government to insurers up-front, then reconciled each year after they were used for services rendered. With President Trump no longer making these payments, insurers increased silver plan premiums by 46% across Kansas and three of its neighboring states as a result.
Kansas remains one of only a few states that has not expanded Medicaid eligibility to cover more low-income adults and provides health insurance to more. Unfortunately, Kansas continues to lose both lives and money as a result.
The Affordable Care Act has expanded individuals’ choices when seeking affordable healthcare coverage in Kansas. Through healthcare marketplaces or exchanges created by this law, more than 20 million individuals now have access to privately offered coverage through privately offered plans. Furthermore, federal grants were given out in support of expanding Medicaid programs throughout states like Kansas.
Medicaid expansion to more low-income Kansans has enabled many Kansans to receive necessary medical care. A recent study demonstrated this improvement by showing lower-income women in states with expanded Medicaid were 25% more likely to receive screening mammograms, and had 6.1% lower mortality rates compared with their counterparts from non-expansion states – an important improvement that should continue being encouraged by governors and lawmakers alike.