The first full year of claims data since the Affordable Care Act insurance marketplace began is now tallied, and it appears rates for Kansans are going up as a result.

That has some state and area health agency leaders concerned, especially for low-income residents.

“The significant increase in health insurance rates projected for 2016 is alarming,” said Kim Polson, interim director of Lawrence’s Health Care Access Clinic. “Even with greater access to insurance through the Health Insurance Marketplace, we find that Health Care Access patients are already unable to afford the monthly premiums or choose plans with a high deductible, which puts the true benefit of having insurance out of reach.”

This Nov. 12, 2014 file photo shows the HealthCare.gov website, where people can buy health insurance, on a laptop screen, shown in Portland, Ore.

Proposed rate increases are not limited to marketplace policies.

Requested average rate revisions range from a decrease of less than half a percent to an increase of 38 percent, the Kansas Insurance Department recently announced. Proposals are for private insurance company health plans sold on the federal marketplace as well as plans not sold on the government website.

In accordance with Affordable Care Act regulations, plans with proposed rate increases more than 10 percent were posted online June 1. A link is available via ksinsurance.org.

The Insurance Commission will review the rates to ensure they’re actuarially sound and accurate before approving them, said Cindy Hermes, Insurance Commission director of public outreach.

Open enrollment to obtain marketplace insurance for the 2016 calendar year begins Nov. 1.

A total of 97 plans — 75 individual and 22 small group — have been proposed for sale in Kansas on the federally facilitated online marketplace, according to the Insurance Commission. Overall, that’s 15 more plans than were available for 2015.

Hermes said Kansas is not alone in facing rate increases.

“The majority of the policies will be more expensive,” Hermes said. “The rates that we’re seeing … are large, and we are concerned about them, and we are going to check them. But the other states are seeing the same types.”

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Hermes and area health advocates suggested two likely culprits of higher marketplace rates.

First, the people who did get insurance through the marketplace — many of whom were previously uninsured — may have been older, sicker and more costly to cover. (Remember the marketing campaigns encouraging more young, healthy people to sign up for insurance? They aimed to counter-balance such costs.)

“In general, since they couldn’t afford insurance, they have poor health outcomes, they didn’t visit the doctor on a regular basis, or they have some type of chronic disease,” said Katrina McGivern, policy and public affairs director for the Kansas Association for the Medically Underserved. “They cost a lot more to insure.”

Also, insurance companies that may have made an educated guess about how much to charge in the new system are now adjusting prices in accordance with actual costs incurred.

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Lawrence agencies point out that they still see many clients with no insurance. Some fear that increased rates will create more.

In 2014, 44 percent of Lawrence-Douglas County Health Department clients were uninsured, and that hasn’t changed drastically since the Affordable Care Act, department director Dan Partridge said.

“The cost of health insurance is one of the factors that influence access to health care,” Partridge said. “And when costs rise, so do the barriers to receiving health care. Increased premiums, that in Kansas are not adequately subsidized, place another burden onto families with limited incomes.”

Polson said the Health Care Access mission is to provide affordable primary care and prescription assistance for uninsured people in Douglas County.

“I predict there will be even more individuals needing services at Health Care Access in 2016 as a result of the projected rate increases,” Polson said.

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Finalized rates and marketplace enrollment are still months away.

The Association for the Medically Underserved leads the navigator program over agencies including Lawrence’s Heartland Community Health Center, and played a big role in getting Kansans enrolled last year, McGivern said.

She urged potential insurance buyers to remember that tax credits should go up in proportion to rates, so that should help offset increased premiums.

Hermes said keeping track of medical expenses starting now, if you haven’t already, will help you be a smart shopper when the time comes to sign up for 2016 plans. Knowing how much you spend helps choose a plan that’s a good fit, she said.

McGivern said she hopes that as previously unhealthy people buy insurance and become more healthy, their healthcare costs will go down and help rates stabilize.

“We’re trying to be optimistic that it is just a growing pain, and that things will level out,” she said.

Marketplace enrollment by the numbers

11.7 million Americans selected plans through the government’s Health Insurance Marketplaces for calendar year 2015. Of those, 10.2 million Americans paid for and activated their policies.

Here are the numbers for Kansas.

• 85,490 Kansans have paid for and activated their policies.

• 69,979 (81.9 percent) receive advanced premium tax credits to make their policies more affordable throughout the year.

• 47,836 (56 percent) receive cost-sharing reductions to lower the out-of-pocket amount they pay for deductibles, coinsurance and copayments.

• The average advanced premium tax credit for Kansans is $210 per month. The national average was $272 per month.

Source: Centers for Medicare and Medicaid Services March 31, 2015, Effectuated Enrollment Snapshot, online at CMS.gov.