The percentage of Kansans without health insurance fell in 2022, fueled partly by people purchasing health insurance on their own.
New census data out Thursday showed the uninsured rate in Kansas fell to 8.6% from 9.2% as more people relied on acquiring their own health insurance aided by tax credits that made buying health coverage less expensive from the Affordable Care Act.
The uninsured rate for Kansas, however, was still above the national average of 8% after it fell from 8.6%.
And the Kansas Health Institute found disparities in coverage for Hispanic Kansans whose uninsured rate of 20.1% was more than three times higher than the 6.3% rate for non-Hispanic white Kansans.
The uninsurance rate for Black or African American Kansans was 10.5% compared to the 6.3% rate for non-Hispanic white Kansans.
The overall decline in the uninsured rate for Kansas was partly attributable to the fact that the state was just one of nine that saw an increase in private health insurance coverage in 2022, the Census Bureau reported.
Nationally, declines in the uninsured rate for a majority of those states stemmed from changes in their public and private coverage rates, according to the Census Bureau.
For seven of the states with lower uninsured rates, including Kansas, the difference was driven by increases in private coverage, the Census Bureau said.
For example, about 17% of Kansans bought their own health insurance directly in 2022, up from 15.9% from a year earlier, the census data show.
The percentage of Kansans getting employer-sponsored health insurance coverage climbed slightly from 57.9% to 58.2%, Census data showed.
Linda Sheppard, strategy team leader for the Kansas Health Institute, pointed to a record number of people enrolling in an insurance plan available from the Affordable Care Act as one reason the state’s uninsured rate is improving.
“Where some other states saw growth in their employer-sponsored coverage, that was not what we saw for Kansas,” Sheppard said.
“I think it is significant that our growth came from the private direct purchase markets, individuals going out and buying that coverage on their own and not from employers.”
The Kansas Health Institute recently reported that a record 124,473 Kansans picked a health insurance plan or were automatically reenrolled in the Affordable Care Act program from Nov. 1 of last year through Jan. 15 of this year.
It was a 40% increase from 2021, when 88,627 people enrolled in the ACA, and a 15.5% bump from 2022, when 107,784 enrolled.
By comparison, there were only about 57,000 Kansans enrolled in the program in 2014, the first year health insurance could be purchased through the online marketplace offered by the Affordable Care Act.
The Census Bureau reported that many states where more people were buying health insurance coverage directly also saw increases in enrollment of 22% or greater in plans available through the Affordable Care Act.
Sheppard noted that health coverage through the ACA became more affordable because the $1.9 trillion COVID-19 stimulus bill passed by Congress two years ago provided for the continuation of a lucrative tax credit that lowered health insurance premiums.
“There were individuals who could get health insurance for very, very, very small amounts of monthly premium, in some cases maybe hardly any at all,” Sheppard said.
“If you’re somebody who wants insurance and were willing to go onto the marketplace to figure out what you were going to be eligible for in terms of financial assistance, it made a whole lot of sense,” she said.
State-level uninsured rates ranged from 2.4% in Massachusetts to 16.6% Texas in 2022.
The District of Columbia was among the lowest with an uninsured rate of 2.9%, not statistically different from Massachusetts.
The uninsured rate placed Kansas 37th out of the 50 states, the census data shows.
At 8.6%, it was the same as Missouri, lower than Oklahoma at 11.7%, but higher than Nebraska at 6.7% and Iowa at 4.5%.
Among states that had not expanded Medicaid, Kansas was lower than Texas at 16.6%, Georgia and Oklahoma at 11.7%, Florida at 11.2%, Mississippi at 10.8%, Tennessee at 9.3% and South Carolina at 9.1%.
The Census Bureau said the uninsured rate in expansion states as a group decreased from
6.8% to 6.3%, while nonexpansion states saw the uninsured rate drop from 12.8% to 11.8%, which was driven by an increase in private coverage.
Sheppard cautioned that the uninsured rate could have been been influenced by a federal law that continuously kept people on the Medicaid rolls during the pandemic without having their eligibility reviewed.
Likewise as states unwind from the end of continuous enrollment provision, they are cutting millions off the Medicaid rolls.
About 79,000 Medicaid recipients have lost their coverage in Kansas during the unwinding process, including 61,000 placed in a 90-day window to submit and complete their eligibility review if they missed a deadline or had more information to report.
“The fact that the federal government was incentivizing states to just leave those people (on Medicaid) and not drop off, there is no doubt there would have been additional folks who probably would have lost that coverage,” Sheppard said.
“Certainly that helped,” she said. “Those folks were able to stay on when in the past they might have dropped off.”
But as people lose Medicaid coverage during the unwinding process, the uninsured rate in Kansas could stand to increase next year, she said.
“That is certainly what we’ve anticipated,” Sheppard said.
“There is this expectation that there are going to be a pretty large number of those folks who were allowed to keep that coverage during the pandemic who are now are going to start dropping off,” she said.
