If tax credits expire, Kansas City will see a major health insurance crisis | Opinion
The expiration of the enhanced advanced premium tax credits for the Affordable Care Act’s health insurance marketplace is not just a policy change. It’s a crisis that is hitting families hard in Kansas City. At the Community Health Council of Wyandotte County, we work tirelessly to promote health equity for our residents by addressing the social determinants of health — such as food security, housing stability and access to health care.
We are witnessing the painful reality of this expiration firsthand. As our clients navigate their options for health insurance in the new year, we see the burden of rising costs weighing heavily on their shoulders. Our dedicated staff from the Kansas Assistance Network and the Community Health Worker initiatives report that more families are choosing to forgo health insurance altogether because of skyrocketing premiums.
The marketplace provides two vital forms of financial assistance: help with monthly premiums and help with out-of-pocket costs. Families earning between 100% and 250% of the federal poverty level qualify for both, but they must select a Silver plan to receive extra savings. Unfortunately, the increase in premiums has made these Silver plans increasingly unaffordable. For instance, one of our insurance specialists, Ellie Ludwig, shared a heartbreaking story about a client whose Silver policy jumped from $30 to $201 per month overnight, despite no change in their income. This client relies on the Silver plan for ongoing health needs, including epilepsy and recent hospitalizations.
Many Kansas Assistance Network clients are now questioning whether insurance is even worth the cost. With the price of Silver plans out of reach, some are forced to consider cheaper Bronze plans, which come with exorbitant deductibles — some as high as $21,000—leaving families to pay health care expenses out of pocket until they reach these limits.
The impact of these changes is profound. One client, a 64-year-old woman with an average income, is losing her advanced premium tax credits entirely. The cheapest available plan is more than $1,000 per month, with copays of $50 to see her primary care provider and $115 for specialist visits. Faced with these crushing costs, she is seriously thinking of going without insurance until she becomes eligible for Medicare in the fall of 2026.
Across our community, families are being forced into an impossible dilemma: Pay higher premiums and risk crippling debt, absorb high deductibles for a low premium, or simply go without coverage altogether. Many cling to the hope that Congress will act to extend the expiring tax credits, which could ease their financial burden and restore their access to care.
The consequences of being uninsured are dire. Families unable to afford health insurance face heightened risks, especially in a region with insufficient safety net clinics. Without access to timely treatment, many will find themselves in emergency rooms, battling life-threatening conditions and accumulating insurmountable medical debt.
Even at the Community Health Council of Wyandotte County’s Community Health Worker, a small nonprofit with just 18 employees, we feel the financial strain of rising premiums. We strive to offer competitive benefits, but the reality is that our own employees now struggle to afford insurance through the ACA marketplace. My family’s premium increased by an additional $700 a month for a plan with high out-of-pocket costs. With two kids in day care, we just can’t afford it. Consequently, the Community Health Council is reevaluating its benefits structure, but budget constraints make any meaningful changes challenging.
Looking ahead to 2026, community-based organizations such as ours will face even greater challenges as the number of uninsured individuals rises. Our Community Health Workers are skilled at navigating the health care landscape, but with limited safety net resources, they will be stretched thin while trying to support those in need.
We urge our community members to take action. Please contact your representatives in Congress and demand that they extend the premium tax credits. Together, we can ensure that every Kansas Citian has the opportunity to access the health care they need and deserve.
Our families’ health and well-being depend on it.
Molly Gotobed is executive director of the 501(c)(3) nonprofit Community Health Council of Wyandotte County.