If you live in Texas and have no health insurance, you are not alone. Texas has the highest uninsured rate of any state in the country. As of 2026, roughly one in five Texans lacks coverage. But being uninsured is not the same as being out of options. Depending on your income, household size, age, and situation, you may qualify for a subsidized marketplace plan, free children's coverage, Medicaid for your pregnancy, or other low-cost care.
This guide walks through every major option available to uninsured Texans in 2026, including income limits, how to apply, and when you can enroll.
Why Texas Has a Large Coverage Gap
Texas never expanded Medicaid under the Affordable Care Act (ACA). That decision created a coverage gap affecting an estimated 570,000 low-income adults who earn too little to qualify for marketplace subsidies but too much to qualify for traditional Medicaid.
Here is how that gap works:
- Medicaid in Texas covers parents with very low income, pregnant women, children, people with disabilities, and adults over 65. It does NOT cover non-disabled adults without children, no matter how low their income.
- ACA marketplace subsidies are available starting at 100% of the federal poverty level (FPL) in Texas because the state did not expand Medicaid.
- Adults who earn below 100% FPL and do not fit a Medicaid category fall into the gap — they do not qualify for either program.
If you are in the coverage gap, there are still options (community health centers, charity care, short-term plans), which are covered later in this guide.
Option 1: ACA Marketplace Plans on Healthcare.gov
Texas uses the federal marketplace at healthcare.gov. If your household income falls between 100% and 400% of the 2026 federal poverty level, you qualify for premium tax credits that reduce your monthly cost.
The enhanced subsidies from 2021 have largely expired for 2026. The subsidy cliff is back, meaning households above 400% FPL no longer receive premium help. However, at lower income levels, plans remain affordable and many Texans at or below 200% FPL can still find a $0-premium option.
2026 ACA Subsidy Income Limits for Texas
| Household Size | 100% FPL (minimum) | 200% FPL | 400% FPL (maximum) |
|---|
| 1 | $15,960/yr | $31,920/yr | $63,840/yr |
| 2 | $21,640/yr | $43,280/yr | $86,560/yr |
| 3 | $27,320/yr | $54,640/yr | $109,280/yr |
| 4 | $33,000/yr | $66,000/yr | $132,000/yr |
| 5 | $38,680/yr | $77,360/yr | $154,720/yr |
| 6 | $44,360/yr | $88,720/yr | $177,440/yr |
| 7 | $50,040/yr | $100,080/yr | $200,160/yr |
| 8 | $55,720/yr | $111,440/yr | $222,880/yr |
| Each additional | +$5,680/yr | +$11,360/yr | +$22,720/yr |
Income between 100% and 400% FPL qualifies for a premium tax credit. Income between 100% and 250% FPL may also qualify for cost-sharing reductions (CSRs) that lower your deductibles and copays if you pick a Silver plan.
For context on where your income falls, check the ACA income limits reference at CoveredUSA.
How to Enroll in a Texas Marketplace Plan
- Confirm your enrollment window. Open enrollment for 2026 plans ran from November 1 through January 15, 2026. Outside that window, you need a qualifying life event to trigger a Special Enrollment Period (SEP).
- Gather your documents. Social Security numbers for household members, income information (pay stubs, tax returns, or estimates for self-employed), and current employer coverage details if applicable.
- Create or log into your account at healthcare.gov.
- Complete your application. Answer questions about household size, income, and whether you are offered employer coverage.
- Compare plans. Use the plan comparison tool to see Bronze, Silver, Gold, and Platinum options. Silver plans unlock CSRs if you qualify.
- Enroll and pay your first premium. Coverage begins the first of the month after enrollment.
You can also call the marketplace at 1-800-318-2596 (TTY: 1-855-889-4325) for help in English and Spanish.
Option 2: Special Enrollment Periods (If You Missed Open Enrollment)
Open enrollment for 2026 ended in January, but that does not mean you are locked out all year. A qualifying life event gives you a 60-day window to enroll in a marketplace plan at any time.
Common qualifying events in Texas include:
- Losing job-based coverage (including when a job ends)
- Losing Medicaid or CHIP coverage
- Moving to Texas or changing your county
- Getting married or divorced
- Having or adopting a baby
- Turning 26 and aging off a parent's plan
- Getting out of incarceration
- Experiencing a significant income change
If you had a life event in the past 60 days, you can enroll right now. Check your eligibility at CoveredUSA to confirm which plans and subsidies you qualify for before you apply.
Option 3: Children's Medicaid and CHIP
Even though Texas has not expanded Medicaid for adults, children have much stronger coverage options. Texas covers kids through two programs based on income:
Children's Medicaid (STAR): Free coverage for children in families earning up to 201% FPL.
CHIP (Children's Health Insurance Program): Low-cost coverage for children in families earning up to 201% FPL (CHIP picks up where Medicaid leaves off, covering children up to a higher income threshold with small enrollment fees and copays).
Texas CHIP and Children's Medicaid Income Limits 2026
| Household Size | Children's Medicaid (up to 201% FPL) | CHIP (201% FPL and above, up to CHIP cap) |
|---|
| 1 child | ~$32,080/yr household | Above that limit |
| Family of 2 | ~$43,416/yr | Above that limit |
| Family of 3 | ~$54,752/yr | Above that limit |
| Family of 4 | ~$66,360/yr | Above that limit |
Children must be under 19, Texas residents, and U.S. citizens or qualifying immigrants. There is no waiting period for children's Medicaid.
How to apply for children's coverage:
- Apply online at yourtexasbenefits.com
- Call 1-800-252-8263
- Visit your local Texas Health and Human Services office
- Apply any time of year — CHIP and Medicaid have no enrollment windows for children
Option 4: Medicaid for Pregnant Women
Texas Medicaid covers pregnant women with household income at or below 198% FPL, regardless of immigration status (for emergency Medicaid). Coverage includes prenatal care, labor and delivery, and postpartum care for up to 12 months.
| Household Size | 198% FPL Income Limit |
|---|
| 1 (pregnant woman alone) | ~$31,601/yr |
| Family of 2 | ~$42,768/yr |
| Family of 3 | ~$53,935/yr |
| Family of 4 | ~$65,340/yr |
Apply at yourtexasbenefits.com or call 1-800-252-8263. Coverage can begin the month you apply, so apply as early in your pregnancy as possible.
Option 5: Medicaid for Adults Who Do Qualify
While Texas has not expanded Medicaid, some adults still qualify under traditional pathways:
- Parents and caretaker relatives with very low income (thresholds are quite low in Texas — typically below 18% FPL for parents)
- Adults with disabilities receiving SSI automatically get Medicaid
- Adults 65 and older who meet income and asset limits
- Blind individuals who meet the SSI criteria
If you receive SSI, you are automatically enrolled in Texas Medicaid. For other adults, check whether your situation qualifies at yourtexasbenefits.com.
Option 6: Community Health Centers and Federally Qualified Health Centers
If you fall into the coverage gap — earning below 100% FPL and not qualifying for Medicaid as an adult in Texas — Federally Qualified Health Centers (FQHCs) provide a safety net. These clinics charge on a sliding scale based on income, meaning visits can cost as little as $20 to $40 out of pocket.
To find a Federally Qualified Health Center near you in Texas, visit findahealthcenter.hrsa.gov or call 1-800-400-2742.
FQHCs offer primary care, dental, mental health services, and prescriptions. They do not require insurance.
Option 7: Free and Charitable Clinics
Texas has a network of free clinics that serve uninsured patients at no cost. Many operate through churches, nonprofits, or hospital systems. Coverage and availability vary by county.
- Dial 2-1-1 (Texas 211) to find local free clinics, food banks, and social services near you
- Search for charitable clinics through the Texas Association of Charitable Clinics at tacc.net
Option 8: VA Healthcare (Veterans Only)
If you served in the U.S. military, you may qualify for VA healthcare regardless of income. VA coverage includes primary care, specialty care, mental health services, and prescriptions at low or no cost.
Eligibility is based on service dates, discharge status, and sometimes income. Apply at va.gov/health-care/apply or call 1-800-827-1000.
Option 9: Short-Term Health Plans
Short-term health plans are available in Texas and can be purchased at any time of year. They are cheaper than ACA plans but come with significant limitations:
- They do not cover pre-existing conditions
- They do not meet ACA minimum essential coverage standards
- Lifetime and annual benefit limits apply
- Mental health and maternity coverage are often excluded
Short-term plans make the most sense as a bridge when you are waiting for ACA open enrollment or a life event to trigger an SEP, not as a long-term solution.
How to Know Which Option Fits You
Your best option depends on your household size, income, age, and family situation. Here is a quick guide:
| Your Situation | Likely Best Option |
|---|
| Income 100% to 400% FPL, qualifying life event | ACA marketplace + SEP |
| Income below 100% FPL, adult, no kids | FQHC or free clinic (coverage gap) |
| Child under 19 in household | Children's Medicaid or CHIP |
| Pregnant | Texas Medicaid for pregnant women |
| On SSI or age 65+ | Texas Medicaid |
| Veteran | VA healthcare |
| Waiting for open enrollment | Short-term plan as a bridge |
The fastest way to find out exactly what you qualify for is to use the free screener at CoveredUSA. It takes about two minutes. Check your eligibility now at CoveredUSA. It takes 2 minutes.
Frequently Asked Questions
Can I get health insurance in Texas if I have no income?
If you have no income or income below the federal poverty level and you are not a parent, pregnant, disabled, or over 65, you likely fall in Texas's Medicaid coverage gap. You would not qualify for Medicaid or marketplace subsidies. Your best options are FQHCs for medical care on a sliding scale and free clinics in your county. If you have any dependents under 19, they may qualify for Children's Medicaid regardless of your income.
What happens if I missed the 2026 open enrollment deadline in Texas?
Open enrollment for 2026 ended January 15, 2026. You can still enroll if you had a qualifying life event in the past 60 days. Common events include losing a job, moving to Texas, having a baby, getting married, or losing Medicaid. If you have not had a qualifying event, your next opportunity is open enrollment for 2027, which starts November 1, 2026.
Does Texas have free health insurance for adults?
Texas Medicaid does not cover non-disabled adults without children at almost any income level, due to the state's decision not to expand Medicaid. However, adults with income between 100% and 200% FPL can often find a $0-premium ACA marketplace plan through healthcare.gov. "Zero premium" means no monthly payment, though you still pay deductibles and copays when you use care.
How much does health insurance cost in Texas in 2026?
Costs vary widely based on income, age, and the plan tier you choose. At incomes below 200% FPL, many Texans qualify for $0-premium Bronze or Silver plans after the tax credit is applied. Between 200% and 400% FPL, you will pay a percentage of your income toward premiums, capped by the ACA's sliding scale formula. Above 400% FPL, you pay full premium with no subsidy.
What is the income limit for the ACA marketplace in Texas in 2026?
To receive a premium tax credit, your income must be at least 100% of the federal poverty level (around $15,960 for a single person in 2026) and no more than 400% FPL (around $63,840 for one person). For a family of four, the range is approximately $33,000 to $132,000 per year.
Can undocumented immigrants get health insurance in Texas?
Undocumented immigrants are not eligible for Medicaid, CHIP, or ACA marketplace plans in Texas. However, pregnant women may qualify for emergency Medicaid coverage for labor and delivery. FQHCs serve patients regardless of immigration status, and many free clinics do as well. Undocumented children may also qualify for CHIP in some states, but Texas does not currently offer that option.
Is CHIP still available in Texas in 2026?
Yes. CHIP remains available in Texas in 2026 for children under 19 whose family income is above the Children's Medicaid limit but does not exceed the CHIP income cap. There is no open enrollment period for CHIP or children's Medicaid in Texas — you can apply any time of year at yourtexasbenefits.com.
How do I find a free clinic near me in Texas?
Call 2-1-1 from any phone in Texas to reach a local helpline that can connect you with free clinics, FQHCs, and other health resources in your area. You can also search online at findahealthcenter.hrsa.gov for federally funded health centers that serve patients on a sliding-fee scale.
