Annual Insurance Update 2026

• Home
• Articles

Annual Insurance Update 2026

Health Insurance in Kansas

Read the Full Report

Executive Summary

In 2024, the uninsured rate for children increased significantly both in Kansas and nationally. In Kansas, the uninsured rate for children jumped from 5.3 percent in 2023 to 7.0 percent in 2024, mirroring a statistically significant national increase from 5.4 percent to 6.0 percent over the same period.

Several factors may have contributed to this increase in uninsured children. One likely influence is the end of the pandemic-era continuous Medicaid enrollment policy, often referred to as Medicaid "unwinding." Medicaid continuous enrollment ended March 31, 2023, starting the "unwinding" process as states resumed eligibility renewals. Kansas completed unwinding by May 31, 2024. A special Affordable Care Act (ACA) marketplace enrollment period (March 2023-November 2024) was available for those who lost Medicaid coverage during this time.

As eligibility redeterminations resumed and the unwinding process concluded in May 2024, some children may have lost coverage through KanCare and not yet transitioned to another source of insurance. In addition, rising premiums for employer-sponsored family health insurance plans in Kansas over the past decade may make dependent coverage less affordable for some families, potentially contributing to higher uninsured rates among children. These factors, along with broader economic and coverage dynamics, may help explain the recent increase in the uninsured rate for children.

Overall, Kansas continued to have a higher uninsured rate (8.5 percent) than the U.S. (8.2 percent). While Kansas' overall uninsured rate remained largely unchanged from the previous year, the national rate increased slightly.

Kansas had the 16th-highest uninsured rate among all 50 states and Washington, D.C., in 2024, a shift of 14 positions from 2009, when Kansas had a lower uninsured rate than the U.S. overall (12.6 percent compared with 15.1 percent) (Figure ES.1). Actively leveraging federal and state policy options to address disparities in insurance coverage would help Kansas close the gap with other states and regain lost ground.

Health insurance coverage in Kansas has improved since the implementation of the Affordable Care Act in 2010, but gains in coverage from the ACA have stalled since 2016. Nevertheless, the COVID-19 pandemic brought several changes not seen in the past decade. Between 2019 and 2024, the COVID-19 pandemic and the end of the public health emergency significantly affected health, coverage, employment and income in Kansas and around the country.

In 2024, employment-based coverage continued to be the most common coverage for Kansans. The rate of employment-based coverage did not significantly change between 2023 and 2024. The rate of public coverage had shown a significant increase since 2009 and peaked from 2021 to 2024 as federal and state policies maintained continuous eligibility in Medicaid and the Children's Health Insurance Program (CHIP).

Although the continuous coverage provisions ended in March 2023 and Kansas resumed eligibility redeterminations in April 2023, completing the unwinding process in May 2024, the rate of public coverage in 2024 remained influenced by transitional enrollment patterns, with rates similar to 2021-2023. The rate of direct-purchase coverage had been in a downward trend from 2016, but has been rising gradually since 2021 as federal legislation extended the special enrollment period for the federally facilitated marketplace and provided more generous tax credits to more people enrolled in ACA plans.

Why Coverage Matters

Health insurance coverage provides financial protection against injury and illness and has been associated with improved health outcomes such as reduced mortality and increased self-reported well-being. Health insurance coverage is therefore an important tool for promoting the health of Kansans.

This Annual Insurance Update 2026 provides information about insurance coverage in Kansas, highlights trends since the year before the implementation of the ACA, and identifies groups that are experiencing disparities in coverage. The analysis facilitates discussion and informs strategies for improving insurance coverage in Kansas.

Policy Changes

Public policy changes expanded health insurance coverage during the COVID-19 pandemic and its immediate aftermath and through much of 2024. The Families First Coronavirus Response Act (FFCRA) provided additional financial assistance to states that maintained eligibility for all Medicaid and CHIP enrollees during the COVID-19 public health emergency. The March 2021 COVID-19 relief legislation, the American Rescue Plan Act (ARPA), extended the special enrollment period through Aug. 15, 2021, and expanded the eligibility for ACA health insurance subsidies to those with incomes above 400 percent of the federal poverty level (FPL). The Inflation Reduction Act (IRA) extended those insurance subsidies through 2025. From March 2022 to August 2025, a low-income special enrollment period allowed consumers with household incomes below 150 percent FPL who would qualify for subsidies in the marketplace to enroll throughout the year.

Medicaid continuous enrollment associated with the COVID-19 public health emergency ended on March 31, 2023. In a process called "unwinding," states restarted the renewal process and were to complete it within 12 months. Kansas had completed its unwinding process as of May 31, 2024. CMS established a special enrollment period for the ACA marketplace from March 31, 2023, through Nov. 30, 2024, for anyone who lost Medicaid coverage during the unwinding.

Uninsured Rate in Kansas

In 2024, almost a quarter million Kansans were uninsured, including 51,114 children and 195,471 adults ages 19-64. This translates to an overall uninsured rate in Kansas of 8.5 percent. The overall uninsured rate in Kansas decreased from 12.6 percent in 2009 to 8.5 percent in 2024. The Kansas uninsured rate was similar to the historic low of 8.3 in 2023.

Likewise, the uninsured rate in Kansas used to be similar to states that have since expanded Medicaid (12.3 percent for Kansas in 2013, compared with 13.0 percent for states that would expand Medicaid). However, in 2014, the year after major provisions of the ACA took effect in some states, the uninsured rate in Kansas was higher than in expansion states as a group (10.5 percent compared with 9.9 percent). The gap continued through 2024 (8.5 percent compared with 6.6 percent). The uninsured rate for Kansas had decreased by one-third (32.6 percent) from 2013 to 2024, while in the expansion states group, it had decreased by half (49.1 percent).

Many uninsured Kansans might have qualified for subsidized coverage but remained uninsured in 2024. Of the estimated 249,403 uninsured Kansans, 36,584 (14.7 percent) might have been eligible for Medicaid or CHIP, even without expansion. Another 168,122 (67.4 percent), including 19,516 children, might have qualified for subsidies on the federally facilitated Kansas health insurance marketplace established by the ACA. If Kansas had expanded its Medicaid program to cover adults up to 138 percent FPL, 63,309 (25.4 percent) uninsured Kansans might have become newly eligible for Medicaid.

Disparities in Insurance Coverage

Although insurance coverage has improved for Kansans overall since 2013, many disparities remain, especially for people from racial and ethnic minority groups and for people with lower incomes.

Non-Hispanic White Kansans as a group experienced the lowest uninsured rate among all racial and ethnic groups (5.6 percent) in 2024. Hispanic Kansans of all race groups were almost four times more likely to be uninsured (22.1 percent) than non-Hispanic White Kansans. Non-Hispanic Black Kansans were twice as likely to be uninsured (11.6 percent) than non-Hispanic White Kansans. Other/multiple race Kansans were about 1.5 times more likely to be uninsured (8.1 percent) than non-Hispanic White Kansans.

In 2024, Kansans with family incomes below poverty level and between 100 and 199 percent FPL were nearly six times more likely to be uninsured than Kansans with family incomes above 400 percent FPL (18.3 percent and 15.8 percent compared with 3.2 percent). Similarly, Kansans with family incomes between 200 and 400 percent FPL were nearly three times more likely to be uninsured than Kansans with incomes above 400 percent FPL (8.3 percent compared with 3.2 percent).

Where does Kansas stand in insurance coverage?

• Prior to full implementation of the ACA, Kansas had an uninsured rate below the national rate and comparable to states that later expanded Medicaid. However, the advantage for Kansas has disappeared. In 2024, Kansas had the 16th-highest uninsured rate among the 50 states and Washington, D.C., a decline of nine positions from 2009.
• The overall uninsured rate peaked at 9.2 percent in 2021, then declined and stabilized from 2022 to 2024, reaching 8.5 percent in 2024 - similar to 2017 levels, three years after the ACA's major provisions took effect.
• The uninsured rate in Kansas (8.5 percent), which has not expanded Medicaid, was higher than the combined rate for Medicaid expansion states (6.6 percent), but lower than the combined rate for non-expansion states (12.1 percent).

How do Kansans get insurance coverage?

• More than half (55.4 percent) of Kansans obtained health insurance through an employer in 2024. The percentage of Kansans receiving employment-based health insurance remained similar during the last decade.
• Employment-based coverage among young adults ages 19-25 increased from 55.7 percent in 2009 to 68.2 percent in 2024, likely because young adults were able to remain on their parents' employment-based insurance under the ACA.
• About 3 in 10 (29.7 percent) Kansans had public coverage in 2024, primarily Medicare, Medicaid or CHIP, an increase from 23.9 percent in 2009.
• Direct-purchase coverage reached a low of 5.9 percent in 2012, prior to implementation of the ACA, then increased to a peak of 8.4 percent in 2016. Rates declined the following years and have since remained comparable to pre-ACA levels. There were no significant changes between 2023 and 2024.

Who are uninsured Kansans?

• Most uninsured Kansans were in their prime working years. Four in 10 (38.5 percent) were ages 26-44, while more than 2 in 10 (23.5 percent) were ages 45-64.
• Nearly half (47.7 percent) of uninsured Kansans were non-Hispanic White, while more than a third (37.2 percent) were Hispanic, of any race.
• Nearly 8 in 10 (77.4 percent) uninsured Kansans had incomes above the poverty line.
• More than 4 in 10 (41.6 percent) uninsured nonelderly adults were employed full time, year-round, and more than 3 in 10 (35.0 percent) worked part time.

Which Kansans are more likely to be uninsured?

• While the overall uninsured rate for Kansans was 8.5 percent, it was 11.6 percent for nonelderly adults ages 19-64, 7.0 percent for children ages 0-18 and 0.5 percent for adults ages 65 and older.
• The uninsured rate for children increased significantly from 5.3 percent in 2023 to 7.0 percent in 2024.
• Adults ages 19-25 and 26-44 were more likely to be uninsured than those ages 45- 64 (14.2 percent, 13.1 percent and 8.8 percent, respectively).
• The ACA allowed young adults under age 26 to remain on their parents' insurance. The uninsured rate for young adults ages 19-25 fell from 24.6 percent in 2009 to 14.2 percent in 2024.
• Hispanic Kansans of any race were nearly four times more likely to be uninsured than non-Hispanic White Kansans in 2024 (22.1 percent compared with 5.6 percent), while non-Hispanic Black Kansans (11.6 percent) were about twice as likely and Kansans of other or multiple races (8.1 percent) were about 1.5 times as likely to be uninsured as non-Hispanic White Kansans.
• Kansans with family incomes below the poverty line were six times more likely to be uninsured than those with incomes above 400 percent FPL (18.3 percent compared with 3.2 percent).
• For Kansas working adults ages 19-64, part-time workers were twice as likely to be uninsured than were those working full time, year-round (17.2 percent compared with 7.8 percent).

How does insurance coverage vary across Kansas counties?

• There was more than a threefold difference between Kansas counties with the highest and lowest uninsured rates for nonelderly adults: 22.4 percent in Seward County in southwest Kansas and 7.2 percent in Johnson County in northeast Kansas. Counties in southwest Kansas generally had higher uninsured rates, while counties in northeast Kansas generally had lower uninsured rates.
• The uninsured rate for nonelderly adults in Wyandotte County was almost three times higher than in neighboring Johnson County and more than twice as high in Leavenworth County (19.9 percent, 7.2 percent and 9.2 percent, respectively).
• More than half of uninsured nonelderly adults (55.2 percent) and just under half of uninsured children (48.8 percent) lived in the state's five most populous counties: Douglas, Johnson, Sedgwick, Shawnee and Wyandotte.
• Frontier counties (those with fewer than 6.0 people per square mile) had the highest uninsured rate for Kansans ages 0-64 (11.7 percent), while the lowest rate (9.2 percent) was in semi-urban and urban counties.

Read the Full Report

Data Sources

• U.S. Census Bureau 2009-19 and 2021-24 American Community Survey Public Use Microdata Sample files (primary data source).
• U.S. Census Bureau 2023 Small Area Health Insurance Estimates (data source for county-level estimates on uninsured rates).
• Kansas Department of Health and Environment & U.S. Census Bureau 2023 Small Area Health Insurance Estimates (data sources for county-specific Medicaid and Children's Health Insurance Program enrollment data).