Children's Mercy Drops ACA Network Coverage for 400 Kansas City Families

The lights in the Children’s Mercy hospital lobby will stay on for the same patients on January 1, 2026, but their insurance cards will not work.

The hospital announced that it will become out of network for residents in the Kansas City metro who purchased health insurance through the Affordable Care Act marketplace. The decision follows Medica's exit from the market in Johnson and Wyandotte counties in Kansas and six counties in Missouri. The hospital estimates that roughly 400 patients will be directly impacted by this shift.

Christy Moreno, a single parent of two daughters in the area, says the news has triggered a cycle of anxiety and financial strain. Her 16-year-old requires frequent specialist appointments at Children’s Mercy for multiple health issues, while her 19-year-old was also a patient until she aged out. Moreno currently pays almost $1,950 a month for a household plan. She has taken on three jobs and secured a home equity loan to manage medical debt. She does not know where else to take her children if they lose access to the hospital.

The hospital’s spokesperson, Lisa Augustine, clarified that the 400 affected patients do not include those treated at the 31 pediatric clinics owned by the hospital. However, those clinics will also be out of network for marketplace clients in the affected counties. Augustine stated that the hospital is committed to delivering specialized care and has created a webpage with updates. The hospital also confirmed it is speaking with other insurance plans to seek inclusion in their networks. Augustine did not respond to questions about whether negotiations were ongoing with other carriers.

Kasey Jackson, a resident of Leawood, Kansas, said her family feels betrayed by the move. Her 13-year-old son is currently halfway through a two-year treatment plan for acute lymphoblastic leukemia at Children’s Mercy. Jackson and her husband sold their beauty brand and retired to care for him. She noted that the hospital is the only regional option for his specific care. Jackson’s social media post about the situation gained viral attention, drawing comments from the celebrity children’s educator Ms. Rachel. Jackson said the family donates to the hospital and participates in fundraising events, making the contract dispute feel personal.

State regulators are monitoring the situation but say they lack the power to force a resolution. Angela Nelson, director of the Missouri Department of Commerce and Insurance, stated that patients should not be used as bargaining chips in contract negotiations. She noted that there is no easy resolution and that the issue did not appear overnight. On the Kansas side, Holli Kroeker, director of communications for the Kansas Department of Insurance, said the department is passing consumer complaints to the Centers for Medicare and Medicaid Services, which holds jurisdiction over network adequacy for individual ACA plans.

Medica, the insurer exiting the local market, did not respond to requests for comment. Katherine Rodriguez, a senior public relations specialist for the Missouri Department of Commerce and Insurance, confirmed that preliminary conversations are underway between the hospital and insurance companies.

David Hawkins, a father of four near Parkville, Missouri, said he and his wife purchased a Medica plan specifically to keep their current pediatrician. They have switched insurance four times in the last four years to maintain that access. Hawkins said he has considered moving to a different state if local options remain limited. His children do not currently require specialists, but he fears an emergency could occur without access to the main hospital.

Kathryn Orr, a self-employed resident of Fairway, Kansas, experienced the consequences of out-of-network care earlier. In 2025, her daughter required a gastroenterology specialist at Children’s Mercy but had to wait until March 2026 for an appointment. Orr’s family ultimately took the child to the Mayo Clinic in Minnesota, paying $5,000 on a credit card for the visit. Orr said the situation highlights the financial risk for families who do not qualify for government subsidies but still struggle to afford care.

The hospital has provided a phone number, (816) 302-1650, for families with questions about their coverage. The change will take effect at the start of next year.