Children’s Mercy Hospital recently announced it will be out of network for Kansas City-area residents who purchased health insurance through the Affordable Care Act marketplace. The change is slated to take effect Jan. 1. The hospital estimates about 400 of its patients will be impacted.
Across the metro, parents are reeling.
“I've been so stressed. I've been crying. I've been very anxious,” said Christy Moreno, a single parent of two. “I've been thinking, do I need to sell my house and move? And then I have to think of my children that are in school. I can't just pick up and move.”
Moreno, who has done freelance translation work for KCUR, has two daughters, a 19-year-old and a 16-year-old. She said the 16-year-old has several health issues that require frequent specialist appointments at Children’s Mercy. She said her older daughter was a Children’s Mercy patient before she turned 18, and her youngest has seen doctors with Children’s since birth.
Moreno said she doesn’t know where else they will go if they lose access to Children’s Mercy. As it is, Moreno struggles to afford health care. She said last year, Children’s Mercy dropped coverage for several other ACA marketplace plans. She had to switch to Medica, the only option that covered Children’s Mercy. Moreno said her monthly premium for her household is almost $1,950, and she’s had to pick up three jobs and take out a home equity loan to pay off medical debt.
“It seems like it's so hard for families like mine who don't qualify for any type of government subsidy, but at the same time we are struggling,” Moreno said. “It just keeps getting harder and harder.”
What Children’s Mercy and other stakeholders are saying
In an emailed statement October 22, hospital spokesperson Lisa Augustine said Medica is leaving the market in Johnson and Wyandotte counties in Kansas and Jackson, Clay, Johnson, Lafayette, Platte and Ray counties in Missouri. She said people with Medica ACA plans who live in other counties and those with employer-sponsored insurance, TRICARE, Medicare and Medicaid will not be impacted.
“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,” Augustine said in an email.
In emails October 27, Augustine said the 400 patients impacted by the change do not include patients at pediatric clinics associated with the hospital. According to its website, Children’s Mercy owns 31 pediatric clinics, most of them in or near the Kansas City metro. Augustine said these clinics will also be out of network for marketplace clients who live in the affected counties.
Augustine said the hospital is focused on helping families navigate their coverage options. She said it’s created a webpage for updates and frequently asked questions. People can also call (816) 302-1650 with questions.
“We are committed to delivering the important and specialized care children need,” Augustine said in an email.
Augustine did not respond to a request for updates, or to a question asking whether Children’s Mercy is talking to other ACA marketplace plans. On the website under frequently asked questions, the hospital said they want to participate in the marketplace.
“We continue to speak with these plans in an effort to seek inclusion in their networks,” the website said.
Leawood resident Kasey Jackson, whose 13-year-old son receives cancer care from Children’s Mercy and is covered by Medica, wants the hospital to be more transparent. Jackson’s family donates to Children’s Mercy and participates in fundraising events, like Big Slick Celebrity Weekend. She said they love the hospital and its staff, but this feels like a betrayal.
“We don't want to call Children's Mercy liars, but we also at the same time do feel like we deserve answers to understand what actually happened behind the scenes with these contracts,” Jackson said.
Jackson’s son has acute lymphoblastic leukemia. He’s about halfway through a two-year treatment plan at Children’s. Jackson said the hospital is the only option for her son in the region.
Jackson said she and her husband sold their beauty brand and retired to care for their son.
“It's shocking because it just shows that it really doesn't matter, like your child could be next,” she said. “It seems barbaric that this is something that is able to happen … some of the most vulnerable, innocent people of our society are suffering because their parents dared to live the American dream and start their own business.”
Jackson’s social media post about the situation went viral, attracting attention from people including the celebrity children’s educator, Ms. Rachel.
Katherine Rodriguez, senior public relations specialist for the Missouri Department of Commerce and Insurance, said the hospital and insurance companies are in preliminary conversations. In a statement October 23, the department’s director, Angela Nelson, said she’s spoken to Children’s Mercy and all of the health insurance plans that will offer individual coverage in Kansas City, Missouri.
Nelson said patients should never be used as bargaining chips in contract negotiations.
“Their health, financial security, and peace of mind should always come first,” she said in the statement. “With that said, I also want to be honest and transparent with Missourians — there is no easy resolution to this situation. It wasn’t created overnight, and it cannot be solved within a news cycle or two.”
The statement said the Missouri Department of Commerce and Insurance has no authority to intervene in contract negotiations between hospitals and insurance companies.
“Contractual disputes between health plans and health care providers are becoming way too common, and there doesn't appear to be an end in sight,” Nelson said in the statement.
On the Kansas side, Holli Kroeker, director of communications for the Kansas Department of Insurance, said the department also reached out to insurers and Children’s Mercy following the announcement it was dropping marketplace coverage. Kroeker said the department is not involved in contract negotiations between payers and providers.
“The Kansas Department of Insurance does not have the statutory authority to review, approve or enforce network adequacy standards for individual health plans sold on the Marketplace,” Kroeker said in an email to KCUR. “CMS (the Centers for Medicare and Medicaid Services) holds network adequacy jurisdiction for Individual ACA Marketplace plans.”
Kroeker said Kansans impacted by the change should reach out to the Consumer Assistance Division of the Kansas Department of Insurance at 785-296-3071 or by email at kdoi.complaints@ks.gov. She said they’ll pass complaints on to CMS.
Medica did not respond to requests for comment from KCUR.
David Hawkins, a father of four near Parkville, Missouri who owns his own business, said he and his wife have health issues. The ACA allowed him to leave his corporate job and have access to health insurance.
Hawkins said they purchased a Medica plan specifically so their Children’s Mercy-affiliated pediatrician took their insurance. He said they’ve switched insurance four times in the last four years so their kids could continue to see the same pediatrician, but now, he may need to find another – or move to a different state.
“I know it's extreme, but we've considered it before when there were previous talks of the ACA being dismantled by other politicians,” Hawkins said. “If Kansas and Missouri are not going to provide accessible plans, then maybe moving to a different state that has more options for us … it seems like a good enough reason to move.”
Hawkins said his kids don’t require any specialists at the moment, but that could always change. And it’s scary knowing they might not be able to access the main hospital or urgent care in case of emergency.
Previous coverage issues
Kathryn Orr, a Fairway, Kansas resident, said her kids have seen a pediatrician affiliated with Children’s Mercy since birth. She and her husband are self-employed, and she said in 2024, she was diagnosed with a cardiac condition. Orr said they had to purchase a marketplace plan for her care that is not in network with Children’s Mercy.
Last year, Orr’s daughter, who was 8 at the time, experienced extreme constipation that caused her to be incontinent and have other health issues. Her pediatrician sent them to a specialist when her daughter didn’t respond to treatment.
She said Children’s Mercy was the only gastroenterology specialist in the region, so in November 2025, they scheduled an appointment with Children’s Mercy even though they were out of network – but the specialist couldn’t see them until March 2026.
Orr said they didn’t have time to wait. Ultimately, her daughter received care at the Mayo Clinic in Minnesota. She said they had to pay $5,000 on a credit card just for her to be seen.
“I feel panicked that there's this significant population now of children and their families who will without a doubt be faced with impossible questions or decisions to be made about accessing care for their children with devastating financial consequences,” she said.
Her daughter is still recovering, but Orr said the situation would never have gotten as bad as it did had she had access to care in her community.
“It doesn't take a kid who's actively sick. I mean, any one of our kids could fall ill or become injured at any time and Children's is it,” Orr said.
