Texas set an enrollment record in 2026, with over 4.17 million residents selecting a plan through the ACA marketplace, up 5% from 2025. About 92% of those enrollees receive advance premium tax credits that reduce their monthly cost, often to zero. If you are uninsured or think your current coverage costs too much, understanding how the 2026 marketplace works in Texas is the first step to getting covered.
Quick Answer: Texas uses the federal healthcare.gov marketplace. In 2026, subsidies are available to households earning between 100% and 400% of the federal poverty level (FPL). A single adult earning up to $62,600 qualifies. Most low-income enrollees still get a $0-premium Bronze plan. Open enrollment runs November 1 through January 15 each year.
Texas did not expand Medicaid, so adults without employer coverage and without a qualifying disability are not eligible for Medicaid regardless of income. The ACA marketplace is the primary option for the roughly 5 million uninsured Texans who are not elderly and not covered through a job.
How Texas ACA Subsidies Work in 2026
The ACA provides two types of financial assistance: premium tax credits (PTCs) and cost-sharing reductions (CSRs).
Premium tax credits lower your monthly bill. They are available to anyone earning between 100% and 400% of the federal poverty level who does not have access to affordable employer coverage or Medicaid. In Texas, the average monthly PTC for 2026 is $667.
Cost-sharing reductions lower your deductible, copays, and out-of-pocket maximum. They apply only to Silver plans and only if you earn between 100% and 250% FPL.
The Subsidy Cliff Is Back in 2026
The enhanced subsidies passed during the COVID era expired at the end of 2025. In 2025, households above 400% FPL still qualified for some credit. In 2026, that ends. Earn a dollar above 400% FPL and you receive no subsidy at all. This affects households earning roughly $62,600 (single) to $128,600 (family of four).
If you are near the 400% line, income management strategies like contributing to a traditional IRA or HSA can reduce your modified adjusted gross income and keep you under the threshold.
2026 ACA Income Limits in Texas
Eligibility for 2026 coverage is based on 2025 federal poverty guidelines. Texas uses the same federal thresholds as every other state.
| Household Size | 100% FPL (min for subsidy) | 250% FPL (CSR cutoff) | 400% FPL (max for subsidy) |
|---|
| 1 | $15,650 | $39,125 | $62,600 |
| 2 | $21,150 | $52,875 | $84,600 |
| 3 | $26,650 | $66,625 | $106,600 |
| 4 | $32,150 | $80,375 | $128,600 |
| 5 | $37,650 | $94,125 | $150,600 |
| 6 | $43,150 | $107,875 | $172,600 |
| 7 | $48,650 | $121,625 | $194,600 |
| 8 | $54,150 | $135,375 | $216,600 |
For each additional person beyond 8, add $5,500 per person at 100% FPL, $13,750 at 250% FPL, and $22,000 at 400% FPL.
Texas exception for lower incomes: Because Texas has not expanded Medicaid, adults who earn less than 100% FPL fall into what is called the "coverage gap." They do not qualify for Medicaid AND they do not qualify for marketplace subsidies. This affects an estimated 800,000 Texans. If this applies to you, check whether you qualify for community health centers, CHIP (if you have children), or pregnancy Medicaid at 198% FPL.
Plan Types Available on the Texas Marketplace
Texas uses healthcare.gov, the federal exchange. Plans are sold in four metal tiers. Platinum plans are rarely offered in Texas, so most enrollees choose among three tiers.
| Metal Tier | What You Pay Monthly | What You Pay When You Use Care | Best For |
|---|
| Bronze | Lowest premium | Highest deductible, often $5,000-$8,000 | Healthy adults who rarely use care |
| Silver | Moderate premium | Moderate cost-sharing | Anyone who qualifies for CSRs (under 250% FPL) |
| Gold | Higher premium | Low deductible, low copays | People with regular prescriptions or planned procedures |
| Catastrophic | Very low premium | Very high deductible ($9,450 in 2026) | Adults under 30 or those with hardship exemptions |
Silver plans are the most valuable if you earn under 250% FPL. The CSR benefit can reduce your Silver plan's deductible from $4,000-$6,000 to as low as $300-$700, which makes it far better than a Bronze plan even if the monthly premium is higher. The subsidy pays the difference in premium.
Texas's Senate Bill 1296, passed in 2021, requires insurers to align premiums in a way that makes Bronze and Gold plans unusually affordable for subsidized enrollees compared to most other states. This means you may find Gold plans in Texas cost less after subsidy than you expect.
How Much Will Coverage Cost in 2026?
Cost depends heavily on your income, household size, age, and the county you live in. Texas has significant geographic variation because healthcare costs differ across the state.
Rough estimates for a single adult:
| Annual Income | Approximate Monthly Premium (after subsidy) | Plan Type |
|---|
| $16,000 (102% FPL) | $0 | Bronze or Silver |
| $24,000 (153% FPL) | $0-$20 | Silver with CSR |
| $35,000 (223% FPL) | $30-$80 | Silver |
| $50,000 (319% FPL) | $100-$200 | Silver or Gold |
| $62,000 (396% FPL) | $200-$350 | Silver or Bronze |
| $65,000 (415% FPL) | Full unsubsidized rate ($400-$600+) | Any tier |
These are approximate figures for a 40-year-old individual. Premiums increase with age and vary by insurer and county. Use the KFF subsidy calculator for a precise estimate based on your ZIP code.
How to Enroll in a Texas ACA Plan
Texas uses healthcare.gov as its marketplace. There is no separate state exchange.
Step 1: Check your enrollment window. Open enrollment runs November 1 through January 15. If you enroll by December 15, coverage starts January 1. If you enroll between December 16 and January 15, coverage starts February 1. Outside of open enrollment, you need a Special Enrollment Period (SEP).
Step 2: Gather your documents. You will need your Social Security number, income information (last year's tax return or current pay stubs), and the Social Security numbers of any household members enrolling.
Step 3: Create or log into your healthcare.gov account. Go to healthcare.gov, create an account if you do not have one, and start a new application. You can also call the federal marketplace at 1-800-318-2596. Texas lists this as the official marketplace phone number.
Step 4: Complete the application. Answer questions about your household size, projected 2026 income, and whether anyone in your household has access to employer coverage. The system will automatically calculate your estimated subsidy.
Step 5: Compare and select a plan. You will see plans from all insurers offering coverage in your county. Sort by total estimated cost, which includes both premiums and out-of-pocket costs. Do not just pick the lowest premium.
Step 6: Pay your first premium. Coverage does not start until you pay your first month's premium directly to the insurer. You will receive information on payment once you select a plan.
Step 7: Confirm your enrollment. You will receive a confirmation from both healthcare.gov and your insurer. Keep this for your records.
Special Enrollment Periods in Texas
If you miss open enrollment, you can still enroll if you experience a qualifying life event. Common SEP triggers include:
- Losing employer coverage or other minimum essential coverage
- Getting married or divorced
- Having a baby or adopting a child
- Moving to a new ZIP code or county
- Gaining citizenship or lawful immigration status
- Losing Medicaid or CHIP eligibility
- Income changes that affect subsidy eligibility
You generally have 60 days from the qualifying event to enroll. Income-based SEPs are processed within 30 days of the reported change.
Major Insurers on the Texas Marketplace in 2026
Coverage options vary significantly by county. The major insurers active on the Texas marketplace include Blue Cross and Blue Shield of Texas, Molina Healthcare, Celtic Insurance (Ambetter), Community Health Choice, and Friday Health Plans. Some insurers do not operate in all counties, particularly rural West Texas and the Panhandle.
When comparing plans, check that your preferred doctors and hospitals are in-network. Narrow networks are common on marketplace plans, even from large insurers. Out-of-network care can be very expensive.
Texas CHIP: Coverage for Children
Children in Texas may qualify for CHIP even if their parents do not qualify for Medicaid or marketplace subsidies. CHIP covers children in households earning up to 201% of FPL. The Texas CHIP program is called Medicaid for children up to a specific income and CHIP for households slightly above that line.
If you are applying for marketplace coverage for your family, children who qualify for CHIP will be redirected to the CHIP application rather than marketplace enrollment.
What Happens to Your Subsidy If Your Income Changes
Because subsidies are based on your estimated income for the year, a mismatch between your estimate and your actual income has financial consequences.
- If you earned less than expected: You receive a refund when you file taxes.
- If you earned more than expected: You may owe money back to the IRS. Earning above 400% FPL at tax time means repaying the full subsidy you received during the year.
Report income changes through your healthcare.gov account as soon as they happen. This keeps your subsidy calibrated and avoids surprises at tax time.
Comparing Texas to Other States
Texas has the largest number of uninsured residents in the country and one of the highest ACA enrollment figures because Medicaid expansion has not filled the gap below 100% FPL. In states that expanded Medicaid, adults below 138% FPL go directly to Medicaid; in Texas, they fall into the coverage gap.
For comparison: California (expanded Medicaid) has Medicaid covering adults up to 138% FPL, meaning its ACA marketplace handles a narrower income band. Texas's marketplace covers a broader income range but leaves a gap at the bottom.
If Texas were to expand Medicaid in a future legislative session, roughly 800,000-1 million adults in the coverage gap would become newly eligible for free coverage.
Getting Free Help Enrolling in Texas
Texas has a network of certified navigators and application counselors who can help you enroll at no charge. Navigator organizations include Every Texan (formerly Center for Public Policy Priorities), which operates statewide. Community health centers in every major city also offer free enrollment assistance.
Licensed insurance brokers can also help you compare plans. Brokers are paid by the insurance company, not by you, so their services are free.
If you want to check your eligibility before talking to anyone, use the CoveredUSA screener at /screener. It takes about 2 minutes and tells you whether you qualify for marketplace subsidies, Medicaid, CHIP, or other programs.
Check your eligibility now at CoveredUSA. It takes 2 minutes.
Frequently Asked Questions
Does Texas have its own ACA marketplace or does it use healthcare.gov?
Texas uses the federal marketplace at healthcare.gov. Unlike some states (California, New York, and others), Texas does not run its own exchange. All enrollment, plan comparisons, and subsidy applications happen at healthcare.gov or by calling 1-800-318-2596.
What is the income limit for ACA subsidies in Texas in 2026?
For 2026 coverage, subsidies are available to households earning between 100% and 400% of the federal poverty level. For a single person, that is roughly $15,650 to $62,600. For a family of four, roughly $32,150 to $128,600. These thresholds are based on 2025 FPL guidelines, which are used to calculate 2026 coverage year eligibility.
Can I get a $0-premium plan in Texas?
Yes. As of 2026, every enrollee earning under 200% FPL has access to at least one $0-premium Bronze plan after the premium tax credit. In many counties, $0-premium Silver plans are also available for households under 150% FPL. The $0-premium does not mean $0 in cost. You still pay deductibles and copays when you receive care.
What if my income is below 100% of FPL in Texas?
Texas did not expand Medicaid, so adults below 100% FPL who are not elderly, pregnant, disabled, or parents of CHIP-eligible children generally do not qualify for either Medicaid or marketplace subsidies. This is the "coverage gap." Options in this situation include community health centers (which charge on a sliding scale), free clinics, and federally qualified health centers. If you are pregnant, you may qualify for Medicaid at up to 198% FPL.
When is open enrollment in Texas for 2026 coverage?
The 2025-2026 open enrollment period ran November 1, 2025 through January 15, 2026. For 2027 coverage, open enrollment begins November 1, 2026. Starting with the 2027 plan year, open enrollment closes December 15, 2026, a shorter window than prior years. Outside of open enrollment, you need a qualifying life event to enroll.
What is a cost-sharing reduction and how do I get one in Texas?
A cost-sharing reduction (CSR) is a benefit that lowers your deductible, copays, and out-of-pocket maximum. CSRs are only available on Silver plans and only to households earning between 100% and 250% FPL. If you qualify, you must pick a Silver plan to receive the benefit. Choosing Bronze or Gold forfeits the CSR. The government pays the insurer directly; you do not apply for CSRs separately.
Is the ACA marketplace in Texas open to immigrants?
Lawfully present immigrants are eligible for marketplace plans and subsidies on the same terms as citizens. This includes green card holders, certain visa holders, refugees, and others with lawful status. Undocumented immigrants are not eligible for marketplace coverage or subsidies but may be able to access community health centers regardless of immigration status.
How do marketplace plans in Texas cover prescription drugs?
All marketplace plans must cover prescription drugs as an essential health benefit. Formularies (covered drug lists) vary by plan. Before enrolling, search for your specific medications on the plan's drug lookup tool, which is available from each insurer's website and from healthcare.gov's plan comparison pages. Generic drugs are typically covered at low cost-sharing; specialty drugs may have high coinsurance even on Gold plans.
