Texas and the ACA Marketplace
Texas uses the federal marketplace at healthcare.gov rather than a state-run exchange. Texans shop during Open Enrollment (November 1–January 15) and can enroll year-round during Special Enrollment Periods. Texas has the highest uninsured rate in the nation, largely because Texas has not expanded Medicaid and many Texans are unaware they qualify for significant subsidies.
Texas Has Not Expanded Medicaid
Texas Medicaid covers very few adults without children. The income limit for a single childless adult is approximately $215/month — effectively excluding the vast majority of working-age adults without dependents. Texas legislators have declined to expand Medicaid under the ACA despite federal funding that would cover 90% of the cost.
This creates a coverage gap: adults earning below $15,650/year (100% FPL) do not qualify for ACA subsidies and are ineligible for Texas Medicaid. Their primary options are community health centers and county indigent care programs.
Who Qualifies for Subsidies in Texas?
If your household income is between 100% and 400% FPL — approximately $15,650 to $62,600 for a single adult in 2026 — you qualify for premium tax credits. With enhanced subsidies extended through 2026, households above 400% FPL may also qualify if their benchmark Silver plan premium exceeds 8.5% of income.
Major Carriers in Texas (2026)
- BCBS of Texas: Largest carrier in Texas. Broad network, available statewide.
- Ambetter from Superior HealthPlan: Often the most affordable option. Narrower network.
- Aetna / CVS Health: Available in major metro areas (Dallas, Houston, San Antonio, Austin).
- Molina Healthcare: Lower-cost option in select Texas markets.
- Oscar Health: Available in select Texas markets. Strong member app experience.
- UnitedHealthcare: Select Texas markets. Broad national network.
Texas Health Insurance Costs in 2026
Benchmark Silver plan premiums in Texas vary significantly by age, county, and carrier. A 40-year-old in Dallas County earning $40,000/year (about 219% FPL) might pay approximately $80-$150/month for a Silver plan after subsidies. The same individual in a rural Texas county might have fewer plan options but similar subsidy amounts.