• Home
• Articles

2026 Affordable Care Act Health Insurance Marketplace

Many enrollees will see a sharp increase in what they pay

Key Points

• The enhanced Advance Premium Tax Credits (APTC) created under the American Rescue Plan Act and extended through the Inflation Reduction Act expired at the end of 2025. As Congress considers legislation that could affect premium assistance, many enrollees are expected to face higher premium costs for plan year 2026.
• Six insurers are offering 64 health insurance plans on the Kansas marketplace. Most counties have at least two insurers offering plans. For the first time, 14 counties have only one insurer.
• The average monthly premium for a benchmark silver plan in Kansas for a family of four in 2026 before applying Advance Premium Tax Credits increased from $1,848 to $2,381, a 28.9 percent increase.
• The deductible for the benchmark silver plan is $4,000 to $6,000 for an individual and $8,000 to $12,000 for a family of four in 2026.
• Enrollees at 100 percent to 150 percent of the federal poverty level, who previously had a $0 or nearly $0 premium with enhanced tax credits, now will pay between 2.1 percent ($27 per month for an individual) and 4.2 percent ($82 per month for an individual) of their income for a silver plan.

Introduction

The 13th annual open enrollment period (OEP) for the Kansas health insurance marketplace created by the Affordable Care Act (ACA) and operated by the federal government through HealthCare.gov began on Nov. 1, 2025, and will end on Jan. 15, 2026. For plan year 2026, coverage for individuals who enrolled by Dec. 15 became effective Jan. 1, 2026. Coverage for individuals who enrolled after Dec. 15 but by Jan. 15 will become effective on Feb. 1, 2026.

For plan year 2026, the expiration of the enhanced premium tax credits, litigation impacting the new requirements under the 2025 Marketplace Integrity and Affordability Final Rule, and the One Big Beautiful Bill Act (OBBBA) have impacted the marketplace. Overall, higher premiums are expected to increase out-of-pocket costs and may influence whether consumers enroll and how they select plans.

This brief provides information about plan options offered for the 2026 plan year, health insurance costs, financial assistance options and factors impacting enrollment.

Plan Options

For the 2026 plan year, six insurers are offering 64 health plans on the Kansas marketplace (Figure 1) ─ a decrease from 2025 when 81 plans were available from seven insurers. The companies include Blue Cross and Blue Shield of Kansas, Inc. (103 counties); Ambetter from Sunflower Health Plan insured by Celtic Insurance Company (91 counties); UnitedHealth Care Insurance Company (35 counties); Oscar Insurance Company (16 counties); Medica Insurance Company (four counties); and Blue Cross and Blue Shield of Kansas City (two counties).

Enrollees from some counties may find fewer options for insurers and plans. For the first time on the Kansas marketplace, 14 counties, mostly in the southwest, have only one insurer (Blue Cross and Blue Shield of Kansas, Inc.) offering coverage. The other 91 counties still have at least two insurers offering coverage like in previous years. The reduction in the number of health plans available on the Kansas marketplace for 2026 is due to one insurer leaving the marketplace nationwide (Aetna Life Insurance Company) and another insurer reducing the number of counties served in Kansas (UnitedHealth Care Insurance Company).

All six insurers are offering expanded bronze, silver and gold plans. One regular bronze plan is currently offered. One insurer is offering a catastrophic plan. For the ninth consecutive year, there are no platinum plans being offered to individuals on the Kansas marketplace. Like in 2025, all plans offered are exclusive provider organization (EPO) plans, which only cover services provided in-network by a "narrow network" of providers, except in an emergency.

Under the ACA, dental coverage is an essential health benefit for children enrolled in an ACA-compliant health plan and is included in the premium cost, but not for adults. Some insurers offer policies with both health and dental coverage for adults, meaning the premium covers both health and dental policies and APTC can be applied.

Alternatively, adults can purchase a stand-alone dental plan, but they also must be enrolled in an ACA-compliant health plan and will be responsible for two separate premiums. APTC cannot be applied to stand-alone dental plan premiums. Sixteen stand-alone dental plans from five insurers are available for 2026.

Health Insurance Costs

The consumer's health care cost depends on their monthly insurance premiums and their out-of-pocket costs for deductibles, co-payments, coinsurance and uncovered services.

Premiums on the Kansas marketplace increased in plan year 2026. The average monthly premium for a benchmark silver plan in Kansas for a family of four before applying APTC is 28.9 percent higher than it was in plan year 2025, which represents the largest increase since 2019. This increase reflects changes in underlying plan premiums and does not capture the additional increase in what consumers would pay for premiums resulting from the expiration of enhanced APTC. Figure 2 shows average monthly premiums across all counties in Kansas for the benchmark silver plan. Insurers cited rising medical and prescription drug costs, anticipated changes to the risk pool, and the impact of expired enhanced tax credits among the reasons that premiums increased.

As shown in Figure 3 , there is considerable variation in monthly premiums across rating areas, which are geographic areas set by the state. For example, the premium for the benchmark silver plan for a couple age 60 ranges from $2,461 in rating area 1 to as much as $4,068 in rating area 4, a difference of $1,607. Premiums vary based on regional factors such as the cost of care, cost of living, and number and type of providers available. Premiums also vary based on specific characteristics of the person being covered, including age, where they live, whether they smoke, and how many people in their family are covered. Higher rates cannot be charged based on gender or for people with preexisting health conditions.

In addition to the monthly premium paid, consumers are responsible for certain out-of-pocket expenses, including deductibles, co-payments and coinsurance when they use services. Except for certain preventative and other services specified by plans, consumers must pay the deductible amount for covered services first before the insurance plan starts to pay. Co-payments or coinsurance are usually required after the deductible is met. The deductible for the benchmark silver plan is $4,000 to $6,000 for an individual, and $8,000 to $12,000 for a family of four in 2026.

ACA marketplace plans also are required to state a maximum out-of-pocket cost, which is the most that consumers could pay for covered services in the plan year. This maximum amount varies by the consumer's income. However, regardless of income (if eligible for marketplace coverage), the maximum amount a consumer could be expected to pay for covered services is up to $10,600 for an individual or up to $21,000 for a family of four, which is higher than last year.

Financial Assistance

The ACA made financial assistance available to marketplace enrollees at certain income levels to help pay monthly premiums and out-of-pocket expenses. Prior to enactment of the American Rescue Plan Act (ARPA) and the Inflation Reduction Act (IRA), consumers with household income between 100 and 400 percent of the federal poverty level (FPL) ($26,500 to $106,000 for a family of four in 2021) were eligible for APTC and spent between 2.0 to 9.83 percent of their income for their insurance premiums. People under 100 percent FPL are generally not eligible for financial assistance on the marketplace.

Under the ARPA and extended through 2025 by the IRA, consumers with household income between 100 and 400 percent FPL ($32,150 to $128,600 for a family of four in 2025) spent between 0 and 8.5 percent of their household income on premiums for a benchmark silver plan. Households with income above 400 percent FPL also were eligible for APTC that capped their premiums for a benchmark silver plan at 8.5 percent of their income. Consumers with household income between 100 and 150 percent FPL ($32,150 to $48,225 for a family of four in 2025) may have qualified for a free or nearly free marketplace plan. These enhanced subsidies expired at the end of 2025.

APTC is based on the cost of the benchmark silver plan but may be used to purchase almost any plan available on the marketplace, regardless of the metal level. With APTC, consumers could select a gold plan with a lower deductible and more benefits, or a bronze plan with a lower premium but fewer benefits. However, APTC cannot be used to purchase a catastrophic plan. Examples of monthly premium costs for each of the metal levels, including the percentage increase in the benchmark silver plan from 2025, are shown in Figure 4 for each of the rating areas.

Figure 5 shows how an individual, a family of four, and a couple in their 60's from Sedgwick County would be impacted by the expiration of enhanced APTC. For a 27-year-old individual making either $1,304 or $3,260 per month, the amount the consumer would pay for coverage without enhanced APTC would be $27 compared to $0 and $275 compared to $130, respectively. Individuals and households at 250 percent FPL will pay double (110 percent) what they would have paid with enhanced APTC. For a couple in their 60's making just above the APTC threshold ($7,068 a month, 401 percent FPL), the premium payment without enhanced APTC is $2,958, or 41.9 percent of their income.

Under the ACA, the rules for cost-sharing reduction (CSR) subsidies remain the same. Consumers with annual household income between 100 and 250 percent FPL ($32,150 to $80,375 for a family of four in 2025) who enroll in silver plans continue to be eligible for CSR subsidies to lower their out-of-pocket expenses. CSR subsidies are not available with any other metal level.

Factors Impacting Enrollment on the ACA Marketplace

There have been a number of regulatory and policy changes in 2025 that could affect enrollment in the marketplace during the current open enrollment period and in future years, including provisions of the 2025 Final Rule, some of which remain stayed by litigation, and the OBBBA, which was signed into law. In addition, although the enhanced Advance Premium Tax Credits (APTC) expired at the end of 2025, Congress continues to debate extending premium assistance. The U.S. House passed legislation to extend enhanced APTC for three years on Jan. 8, 2026. However, the Senate has not acted as of Jan. 14, 2026. Together, these developments create uncertainty for consumers as enrollment decisions are being made for plan year 2026.