Affordable Care Act

Susie Fagan / Heartland Health Monitor

Supporters of expanding Medicaid in Kansas hope the story of how the conservative governor of another red state found a way to move forward will motivate Gov. Sam Brownback and Republican legislative leaders to do the same here.

They invited a delegation of hospital officials from Indiana to come and talk about how they worked with Republican Gov. Mike Pence and large GOP majorities in the Indiana Legislature to pass a conservative plan that expanded health coverage to more than 350,000 low-income residents of the Hoosier state but required them to share in the costs.

Dave Ranney / Heartland Health Monitor

When Rep. Jim Ward read the latest lawsuit brought by Kansas officials against the Affordable Care Act, the Wichita Democrat thought the federal action at the center of the suit sounded familiar.

“My first thought was, ‘Wait a minute, didn’t we just do this about four months ago?’” Ward said, referring to the Legislature increasing a tax on health plans.  “And why is one better than the other?”

Republican state leaders who initiated the lawsuit say it’s an essential part of their ongoing fight against federal overreach by President Barack Obama’s administration.

A major provider of health insurance in Kansas is pulling out of the Affordable Care Act marketplace.

Two companies under the same corporate umbrella — Coventry Health & Life Insurance Co. and Coventry Health Care of Kansas Inc. — are withdrawing from the marketplace just two weeks before the Nov. 1 start of the next open enrollment period.

Rohan Hutchings, a Coventry spokesperson, said company officials made the decision after reviewing a range of business factors, including the company’s competitive position in the 17 states in which it offers marketplace plans.

Iowa Healthcare Collaborative

Roughly 1,000 Kansas doctors soon will be participating in a massive nationwide initiative aimed at improving the quality and efficiency of the health care system.

The Kansas doctors will be part of a six-state transformation project managed by the Iowa Healthcare Collaborative, a nonprofit organization formed in 2004 by doctors and hospitals in the state.

Dr. Tom Evans, the CEO of the Iowa collaborative, said each of the participating states will be free to focus on its own improvement strategy.

Both Kansas and Missouri are underperforming when it comes to reducing the number of uninsured within their borders.

From 2013 to 2014, all 50 states recorded statistically significant reductions in their uninsured rates, mostly because of the implementation of key provisions of the Affordable Care Act, according to new data from the U.S. Census Bureau.

But most states saw bigger reductions than those posted in Kansas and Missouri.

The number of Kansans maintaining health coverage through, the federal online marketplace, has declined since spring.

As of the end of June, 84,872 Kansans were enrolled in Affordable Care Act policies, according to the U.S. Department of Health and Human Services. That’s down 0.7 percent from the nearly 85,490 enrolled at the end of March but higher than the 57,000 enrolled in the spring of 2014.

In Missouri, enrollment decreased to 212,256 in June from 219,953 in March, a decline of 3.5 percent.


The Centers for Medicare and Medicaid Services announced Wednesday that it had renewed its navigator grants with two Kansas programs: Ascension Health and the Kansas Association for the Medically Underserved (KAMU).

Premiums for Kansas health insurance plans offered in the federal marketplace won’t increase as much as originally proposed, state Insurance Commissioner Ken Selzer said Tuesday.

In May, Kansas insurance companies requested rate increases of up to 39 percent for individual market policies to be sold through the marketplace during the next open enrollment period, which begins Nov. 1 and ends Jan. 31, 2016.


The proportion of Missourians without health insurance fell by 4.3 percentage points from 2013 to the first half of 2015, according to Gallup survey results published Monday.

The rate of uninsured Missourians now stands at 11.4 percent, compared with 15.2 percent in 2013.

The decrease occurred even though Missouri neither expanded Medicaid nor set up its own state-based marketplace under the Affordable Care Act.

REACH Healthcare Foundation and Mid-America Regional Council

When it comes to health outcomes in the 11-county Kansas City metropolitan area, there’s good news and there’s bad news.

That’s the takeaway from a regional health assessment released Tuesday by the REACH Healthcare Foundation in Merriam, Kansas, which aims to improve health care for the poor and medically underserved.

The good news: Except for obesity and diabetes, health outcome trends in the metro area are improving.

The U.S. Supreme Court’s rejection of the latest legal challenge to the Affordable Care Act preserves federal tax subsidies that nearly 270,000 consumers in Kansas and Missouri used to help them purchase health insurance.

If the decision handed down Thursday had gone the other way, those consumers, many of whom were previously uninsured, might have been forced to drop their coverage.

RELATED: High Court Upholds Health Law Subsidies 

Reactions to today’s U.S. Supreme Court ruling upholding a key pillar of the Affordable Care Act – the federal tax subsidies made available through the federal insurance marketplace:

U.S. Rep. Emanuel Cleaver (D-Mo.): “The Supreme Court has said it again and again: The Affordable Care Act is the law of the land. Today’s decision saves lives. The ACA is helping millions of Americans focus on their families, jobs, and quality of life, instead of worrying about what will happen if they and their family members get hurt or sick. Now I am no lawyer—I am simply a United Methodist preacher. 

High Court Upholds Health Law Subsidies

Jun 25, 2015
Jim McLean / Heartland Health Monitor

The Affordable Care Act survived its second Supreme Court test in three years, raising odds for its survival but by no means ending the legal and political assaults on it five years after it became law.

Alex Smith / Heartland Health Monitor

Early on a Monday morning, percussionist and music teacher Amy Hearting of Kansas City reads a newspaper outside a coffee shop before going off to teach an elementary school workshop.

She loves her work but says she’s not in it for the benefits and certainly not for the big salary.

“I feel like I’m doing what I want to be doing in life,” Hearting says. “Unfortunately, it doesn’t come with health insurance, and it doesn’t really come with an annual income where that is an easy reality for me.”

Attorneys general in 10 states, including Kansas, have asked a congressional committee to investigate efforts by the Obama administration to “coerce” states to expand their Medicaid programs by withholding unrelated healthcare funds.

With a U.S. Supreme Court decision on Affordable Care Act subsidies looming, state preparations again have exposed deep political divides over the federal health care law.

Democratic governors in Pennsylvania and Delaware moved to protect their residents’ federal health insurance subsidies in advance of a ruling in the King v. Burwell case, which could come before the end of the week.

NPR's legal affairs correspondent Nina Totenberg talks about two impending supreme court decisions that will determine the future of the Affordable Care Act, and same-sex marriage itself. 


It’s shaping up as a make-or-break moment for the Affordable Care Act.

The U.S. Supreme Court will rule in a week or two on a challenge to Obamacare subsidies that could affect 6.4 million Americans. That’s roughly how many people obtained tax credits through health insurance exchanges operated by the federal government.

Thirty-four states chose not to set up their own marketplaces, or exchanges, and the lawsuit before the court contends the Affordable Care Act only provides for subsidies through state-operated exchanges.  


Two of the three companies that sell individual-market policies for Kansans on the federally administered health insurance marketplace are proposing significant premium increases for 2016.

Rate increases proposed by Blue Cross and Blue Shield of Kansas, the state’s largest insurer, range from 35 percent to 39 percent. Aetna and Coventry Health Company, which merged in 2013, requested rate increases of 20 percent to 35 percent.

The Kansas Insurance Department on Tuesday said that premiums for some individual and small-group health plans are likely to increase by as much as 38 percent for 2016.

The projection is based on an early review of health insurance companies’ requests for raising rates.

The proposed increases, which are not yet public, were filed with the department on or before May 1.

“It’s safe to say that most — but not all — of the major carriers in the state are proposing double-digit rate increases,” said Clark Shultz, the department’s director of governmental affairs.

Dave Ranney / Heartland Health Monitor

Sen. Mary Pilcher-Cook, a Republican from Shawnee, said the fee would generate between $18 million and $24 million annually.

The money, she said, would be deposited in a fund that would be used to offset costs associated with the state’s Medicaid program and its implementation of the Affordable Care Act, also known as Obamacare.

“We are doing this not because of the budget hole,” Pilcher-Cook said Wednesday, referring to the Legislature’s ongoing debate over how to fill a more than $400 million gap in the state’s budget for next fiscal year, which begins July 1.

Kaiser Family Foundation

Some state legislatures are moving to shield residents’ federal health insurance subsidies in advance of a U.S. Supreme Court decision regarding the Affordable Care Act.

The Kansas Legislature is not among them.

As Kansas lawmakers work toward a tax plan to end the 2015 session, they have not had any briefings on the King v. Burwell case, the verdict expected in June or its implications for the nearly 100,000 Kansans who purchased insurance from, the online insurance exchange.

Bryan Thompson / Heartland Health Monitor


Accountability. It means taking responsibility for an action or result.

Lately, it’s taken on a new connotation in the field of health care. The Affordable Care Act provides a way for health care networks to get bonus payments by providing better care, and keeping Medicare patients healthier.

These Accountable Care Organizations are about to have a larger presence in Kansas.

Kansas has been slow to adopt Accountable Care Organizations, or ACOs. Fewer than 4 percent of the population is enrolled in some form of alternative payment model, like ACOs.

The stakes for Kansas to expand Medicaid have been raised.

The state received notice from the Centers for Medicare and Medicaid Services last week that if it doesn’t expand its Medicaid program, it would lose federal funding for uncompensated health care, according to officials from the Kansas Department of Health and Environment.

The federal government provides money for the state’s uncompensated care pool to reimburse health care providers who serve the uninsured.

Jim McLean / Heartland Health Monitor

Sherri Calderwood’s Obamacare story isn’t unique.

It’s probably similar to those that could be told by many of the nearly 100,000 Kansans who have so far purchased coverage in the Affordable Care Act marketplace known as

Calderwood looked into signing up for an Obamacare plan during the first enrollment period but concluded she and her husband couldn’t afford it. 

Mike Sherry / Heartland Health Monitor

States that opted to use the federal health insurance marketplace instead of establishing one of their own can’t restrict the ability of certified navigators to help consumers, a federal appeals court ruled Friday.

The decision by the 8th U.S. Circuit Court of Appeals largely affirms an earlier ruling by a federal district court that blocked implementation of a Missouri law.

Twice as many Kansans and Missourians signed up for health insurance this year under the Affordable Care Act compared with the first enrollment period last year, new figures released Tuesday show.

More than 250,000 Missourians and nearly 100,000 Kansans selected plans on the federal insurance exchange, according to the Department of Health and Human Services.

The data reflects complete enrollment numbers for the period from Nov. 15, 2014, through Feb. 15, 2015, and includes additional special enrollment activity through Feb. 22.

More than 300,000 consumers in Kansas and Missouri have a stake in the case argued Wednesday in the U.S. Supreme Court over a provision in the Affordable Care Act.

The vast majority of people who purchased Affordable Care Act coverage in both states qualified for federal tax credits. But they could lose those credits if the court rules that only consumers using state-based marketplaces are entitled to them.

Gallup is out with a new poll showing falling uninsured rates in every state but one: Kansas.

Although not statistically significant, the Sunflower State’s 1.9 point increase makes it the only state in the country to witness an uptick.

Philip Taylor / Creative Commons-Flickr

So you file your income tax return, and find you owe Uncle Sam $500—not for taxes, but for not having health insurance last year. The penalty is $95 per adult, or 1 percent of income—whichever is greater. Fifty-thousand dollars of income works out to a $500 penalty.

As many as 6 million individuals and families may have to pay this year. If you don’t have insurance for 2015, your penalty next year will rise to $325 per adult, or 2 percent of income, whichever is greater. But the enrollment period ended Feb. 15.