TOPEKA — Kansans are uninsured at a rate higher than the rest of the country for a third-straight year, but the effects of Medicaid “unwinding” have yet to be seen, recent U.S. Census Bureau data shows.

More than 240,000 Kansas residents are without health insurance, which translates to an uninsured rate of 8.4%, according to American Community Survey data, which was released Sept. 12.

The national uninsured rate is just below 8%, and 2023 is the third year in a row Kansas’ rate has exceeded the national one, according to the Kansas Health Institute, a Topeka-based nonpartisan research organization. However, the 2023 Kansas uninsured rate is an improvement from 2022, when it was at 8.6%.

“While the effects of policies such as the unwinding of the continuous enrollment provisions in Medicaid and the continuation of enhanced subsidies for the federally facilitated marketplace may have combined with other trends in 2023 to keep the uninsured rate steady for Kansans, we expect that those policy effects may not be fully seen until at least next year’s release,” said Kari Bruffett, KHI president and chief executive officer, in a news release.

COVID-19 policies required Medicaid programs to keep people continuously enrolled in their health insurance until the end of the public health emergency unless the person moved away, died or requested to end coverage. During that time, enrollment in KanCare, as Medicaid is known in Kansas, increased from 410,000 to 540,000 people.

Beginning in April 2023, states began “unwinding” these pandemic-era protections, which, in Kansas, resulted in roughly 114,000 people losing coverage as of August. Kansas completed its unwinding in May.

“In addition, the data tell us that wide disparities in insurance coverage continued in 2023, and data that will be released this fall will allow us to describe more completely the experiences of Kansans across the state,” Buffett said.

Latino Kansans were uninsured in 2023 at a rate of 20%, which was four percentage points higher than the national uninsured rate among Latinos. Nearly 11% of Black Kansans were uninsured in 2023 while white Kansans were uninsured at a rate of nearly 6%. People with incomes below the federal poverty threshold, which was about $30,000 annually for a family of four in 2023, were uninsured at a rate of nearly 17%, according to the survey data.

Kansas is one of 10 U.S. states that have not expanded Medicaid eligibility requirements to include most adults who make up to 138% of the federal poverty threshold. That’s $20,783 or less for an individual and no more than $43,056 for a family of four. In Kansas, the eligibility requirements to qualify for KanCare are much more stringent. Children, their parents, pregnant women, seniors and people with disabilities qualify for KanCare if their household income falls within varying levels of the poverty threshold. Parents qualify for coverage if their yearly earnings are less than 38% of the federal poverty threshold, which is about $11,900 or less for a family of four in 2024. 

Nationally, the uninsured rate for those making less than 138% of the poverty threshold “significantly decreased” in 2023, but Kansas’ decrease wasn’t significant, KHI said.

In February, KHI estimated a Medicaid expansion plan proposed by Democratic Gov. Laura Kelly would provide coverage to 152,000 low-income Kansans, including 45,000 children, with no net cost to the state for eight years. The GOP-led Legislature blocked the plan from advancing.

The Kansas and national uninsured rates are both at their lowest since 2009, according to the survey data. Uninsured rates in Kansas and the rest of the country peaked in 2010 at nearly 14% and 15.5% respectively.