KANSAS CITY, Mo. — KSHB 41 reporter Elyse Schoenig covers Johnson County. She also focuses on issues surrounding the cost of healthcare, saving for retirement and personal debt. Share your story idea with Elyse.
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Children's Mercy Hospital (CMH) will no longer be an in-network provider for Affordable Care Act (ACA) Marketplace plans in the Kansas City metro area starting Jan. 1, according to the hospital.
Kasey and Tim Jackson are processing news that their 13-year-old son will no longer have his cancer treatment covered at Children's Mercy, after the hospital announced ACA insurance changes Wednesday.
"Our broker officially emailed us a couple days ago and said, 'So, Children's Mercy finally updated their website, and there are no options that are in network for 2027,'" Kasey Jackson said.
Children's Mercy said Thursday the exit of Medica's ACA plan impacts around 400 Children's Mercy patients, and that the metro's other ACA plans are not under contract with the hospital to be in-network next year.
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Medica, an insurer that provides ACA coverage, is leaving Wyandotte and Johnson counties' ACA Marketplace coverage in 2027, according to the Kansas Department of Insurance. KSHB 41 reporter Elyse Schoenig reached out to Medica for a statement on its exit.
"Last year there was only one provider that was available to us. So, obviously, that was the provider that we took because that was the only option," Jackson said.
The Jacksons are entrepreneurs who have to go through the ACA. Medica was their only ACA option that covers care at Children's Mercy.
Travis Allen is an independent health insurance broker with AIS Health Insurance Advisors in Overland Park.
"(This) leaves those people in a really tough spot for sure," Allen said. "A lot of times you'll see carriers leave, and that's one of the issues we're seeing."
Allen said he sees ACA marketplace providers, policies, plans and deductibles change every year.
"Medica, the company that had (CMH) last year, was one of the most expensive plans, and was pretty unaffordable for a lot of people unless they were super high income or they got a really good tax credit," Allen said.
He said ACA coverage loss is not unique to this hospital or to this year.
"It's not just Children's Mercy. It's not just Kansas City. It's a pretty big national issue when you're trying to get to those best of the world specialty type doctors," Allen said.
The Jacksons said they still want answers and more time.
"What are parents supposed to do?" Jackson asked.
The Missouri Department of Commerce and Insurance and the Kansas Department of Insurance said they didn't know about Children's Mercy's concerns prior to Tuesday.
Read the full statement from Children's Mercy leaders below.:
"Beginning Jan. 1, 2027, the Medica Affordable Care Act (ACA) Marketplace plan has decided to exit the market in the following counties: Johnson and Wyandotte counties in Kansas and Clay, Jackson, Johnson, Lafayette, Platte and Ray counties in Missouri . The change affects approximately 400 current Children’s Mercy patients who live in these counties and are covered by the Medica ACA plan. Medica ACA members outside these counties should not be impacted. This change also does not affect Medicaid, Medicare, employer-sponsored insurance (through work), TRICARE or other commercial insurance. The other ACA plans servicing the KC metro were previously out of network with Children’s Mercy and have elected not to contract with Children’s Mercy in 2027.
"We know this news is hard to hear, especially for families whose children are in treatment, and we want you to know we’re here to help. First, we want to remind our families with Marketplace plans that your Children’s Mercy team remains in-network through the end of 2026, and they should continue to attend upcoming appointments.
"Our team is also available to help families navigate their options for 2027. A first step for impacted families with children in care is to contact their insurance company to ask about continuity-of-care options. Additional support is available through Children’s Mercy’s Financial Resources and Billing [childrensmercy.org] or Patient Access – Financial Clearance at 816-302-1650."
This story was reported on-air by a journalist and has been converted to this platform with the assistance of AI. Our editorial team verifies all reporting on all platforms for fairness and accuracy.
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