Losing a job in Texas carries a health insurance risk that residents of the 40 expansion states plus DC do not face: the Medicaid coverage gap. Texas is one of 10 states that did not expand Medicaid under the Affordable Care Act, so Texas Medicaid for adults stays limited to narrow groups: pregnant women, parents and caretakers with income far below the poverty line, people with qualifying disabilities, and older adults who meet asset tests. A laid-off single adult in Texas with no dependents almost never qualifies for Texas Medicaid, however low income falls in 2026. The federal loss-of-coverage Special Enrollment Period (SEP) gives you a 60-day window from your last day of employer coverage to enroll in an ACA Marketplace plan at healthcare.gov. Under Section 9831 of HIPAA and the federal Marketplace rules, an involuntary loss of employer-sponsored minimum essential coverage is a qualifying life event (QLE) that opens this window. Open Enrollment for 2027 coverage begins November 1, 2026, and the exact closing date should be confirmed at healthcare.gov. Texans who lose job coverage should treat the 60-day Marketplace SEP as the primary safety net, because Texas Medicaid does not serve as the fallback it does in expansion states.
Texas residents shop for Marketplace coverage at healthcare.gov, because Texas does not run its own state Exchange. Texas Medicaid and Texas CHIP are administered by the Texas Health and Human Services Commission (HHSC), and applications go through YourTexasBenefits.com. For most laid-off Texans, the income calculation decides everything. Projected 2026 household income between 100% and 400% FPL ($15,960 to $63,840 for a single person in 2026) qualifies you for premium tax credits that usually make Silver and Bronze plans far cheaper than COBRA. The 400% FPL subsidy cliff returned for 2026 after the enhanced credits expired on January 1, 2026, so income above that line receives no credit. Unemployment benefits from the Texas Workforce Commission (TWC), payable for up to 26 weeks, count as Modified Adjusted Gross Income (MAGI), so include them in your projection. Texas CHIP covers children under 19 up to 201% FPL ($66,330 for a family of 4 in 2026) year-round, even when a parent is ineligible. Insured group plans may also offer Texas state continuation coverage, covered in the sections below.
6 Steps to Get Coverage
Common Mistakes That Cost People Thousands
The costliest mistakes Texans make after losing job-based coverage in 2026:
- Assuming Texas Medicaid will cover you after a job loss. Texas did not expand Medicaid, so most non-elderly adults without children or a disability do not qualify no matter how low income falls in 2026. The Marketplace SEP at healthcare.gov is the main path.
- Waiting for the COBRA election notice before shopping. The Marketplace SEP clock runs for 60 days from your coverage loss date, not from the date you receive paperwork, so start your healthcare.gov application right away.
- Reporting your old salary instead of projected 2026 income. Using last year's pay can shut you out of premium tax credits or push you into the wrong plan tier, so include unemployment benefits and expected new wages only for the rest of 2026.
- Ignoring Texas state continuation. Employees on insured group plans may qualify for up to nine months of state continuation, or six months added after COBRA ends, but only with a written request within 60 days.
- Forgetting the children. Texas CHIP covers children under 19 up to 201% FPL year-round, even when a parent is ineligible for Texas Medicaid, so a family can mix a Marketplace plan for adults with CHIP for kids.
The Texas Medicaid Coverage Gap After Job Loss in 2026
Texas chose not to expand Medicaid under the Affordable Care Act, which creates a coverage gap that hits laid-off workers hard. In the 40 expansion states plus DC, any adult with income under 138% FPL (about $22,025 for one person in 2026) qualifies for free Medicaid. Texas Medicaid, run by the Texas Health and Human Services Commission, does not follow that rule. Texas Medicaid for adults covers pregnant women up to 198% FPL, parents and caretakers with very low income, people with qualifying disabilities, and older adults. A single adult or childless couple who just lost a job falls outside every category, even at zero income. KFF analysis shows hundreds of thousands of Texas adults sit in this gap, and Texas has long had one of the highest uninsured rates in the nation. Check current limits with HHSC at hhs.texas.gov before assuming you do or do not qualify.
Adults under 100% FPL in Texas ($15,960 for one person in 2026) generally cannot receive Marketplace premium tax credits, because the credits start at 100% FPL. Texas residents just above that line often find strong value, since 2026 premium tax credits can bring benchmark Silver coverage to a small monthly payment, and cost-sharing reductions improve Silver plans for incomes up to 250% FPL. Workers who expect part-year income may land above 100% FPL for the full year even if current monthly income is low, so estimate annual 2026 income carefully, including severance and unemployment benefits. Children are the exception that matters most: Texas CHIP covers kids up to 201% FPL ($66,330 for a family of 4 in 2026) year-round, so parents can focus on their own coverage while children keep care. Screen your household at YourTexasBenefits.com before choosing a Marketplace plan, and recheck eligibility whenever your household income or family size changes during 2026.
Texas State Continuation Coverage and COBRA in 2026
Federal COBRA lets you keep employer group coverage for 18 months after most job losses, at up to 102% of the full premium in 2026, with a 60-day election window after the qualifying event. Texas adds a state layer under Texas Insurance Code Chapter 1251. Texas state continuation applies to insured group hospital, surgical, or major medical policies, and you must have been covered for at least three consecutive months before termination. You must send a written request to your employer within 60 days of the later of your coverage end date or the date you receive notice. Coverage lasts up to nine months for people not eligible for COBRA, or six extra months after COBRA ends. Premiums equal the contribution your employer required plus 2% of the group rate, and the first payment is due within 45 days of your election. Self-funded employer plans are generally governed by federal law, so ask HR which type you have.
State continuation ends early if you become eligible for similar group coverage, Medicare, or stop paying premiums, and eligibility alone is enough to end it, even if you never enroll. That rule makes a spouse's employer plan or a new job's plan a clean handoff. Texas state continuation and COBRA both run outside the Marketplace SEP clock, so electing one never extends your 60-day healthcare.gov window. A practical approach for Texans in 2026: apply at healthcare.gov within the first weeks to lock in a subsidized plan, price it against COBRA and state continuation, and keep continuation only if a specialist, a treatment plan, or a substantially met 2026 deductible makes the higher premium worthwhile. Employer and insurer notices arrive by mail, so call HR to confirm dates and request the written notice if it has not come. Calendar your COBRA, state continuation, and Marketplace deadlines separately so none expires unnoticed.
Documents and Proof for a Texas Marketplace SEP Application in 2026
The Marketplace SEP for loss of coverage often requires proof of the qualifying life event, and healthcare.gov may place your application in pending status until you upload it. Each document has a job. A termination letter or COBRA notice proves the date employer coverage ended and starts the 60-day clock. Texas Workforce Commission unemployment letters and recent pay stubs support your projected 2026 income, which drives the premium tax credit. Social Security numbers and immigration documents let the Marketplace verify identity and eligibility. Proof of Texas residency confirms which plans you can buy by ZIP code. After enrollment, the Marketplace sends Form 1095-A in early 2027, and you use it with IRS Form 8962 to reconcile advance premium tax credits against actual 2026 income. Report income changes at healthcare.gov during the year to avoid repayment at tax time. Upload clear scans, keep copies, and respond to any request for documents within the deadline printed on the notice.
Frequently Asked Questions
What is the SEP window after losing a job in Texas in 2026?
Texas residents get a 60-day Special Enrollment Period (SEP) from the day employer coverage ends, and you can also start applying up to 60 days before. For example, if your last day of coverage is October 31, 2026, your window runs November 1 through December 30, 2026. Apply at healthcare.gov, where Texas plans are listed by ZIP code. Plans selected in the month after coverage ends generally start on the first of the following month. Open Enrollment for 2027 begins November 1, 2026, so confirm the closing date at healthcare.gov if your SEP window overlaps with it. Texas Medicaid and CHIP applications at YourTexasBenefits.com are open year-round with no deadline.
Does Texas Medicaid cover adults who lost their jobs in 2026?
Texas Medicaid rarely covers laid-off adults in 2026. Texas did not expand Medicaid under the ACA, so adult eligibility depends on a category: pregnancy (up to 198% FPL), parenting a minor child with very low income, a qualifying disability, or age 65 and older. A single adult without children almost never qualifies, even with zero income. Apply or screen at YourTexasBenefits.com, run by the Texas Health and Human Services Commission (HHSC), to confirm the current limits. If you do not qualify, the Marketplace SEP at healthcare.gov is your main path, with premium tax credits starting at 100% FPL ($15,960 for one person in 2026).
What does the Texas coverage gap mean if I lost my job?
The Texas coverage gap affects adults with projected 2026 income under 100% FPL ($15,960 for one person) who do not meet a Texas Medicaid category. Marketplace premium tax credits start at 100% FPL, and Texas Medicaid is closed to childless adults, so no subsidy path exists on paper. In practice, estimate your full-year 2026 income carefully: severance and earlier paychecks from this year may push you above 100% FPL, which unlocks credits. Check healthcare.gov for $0 Bronze options, and ask a navigator or 2-1-1 Texas about local clinic and charity care programs if you remain in the gap.
Is COBRA worth it after losing a job in Texas in 2026?
COBRA costs 102% of the full premium in 2026, typically $500 to $900 per month for an individual and $1,200 to $2,800 per month for a family. COBRA makes sense when you are mid-treatment with a specialist outside Marketplace networks, or you have nearly met your 2026 deductible and want that credit to continue through December 31. For most Texans with projected income between 100% and 400% FPL, Marketplace plans with premium tax credits cost much less. You have 60 days to elect COBRA, and electing it does not extend your Marketplace SEP window, so compare both before Day 60.
How do I prove my job loss for the SEP at healthcare.gov in Texas?
Upload one document that shows the date your employer coverage ended when healthcare.gov asks for proof of your qualifying life event. Accepted proof usually includes a termination or layoff letter from your Texas employer, a COBRA election notice, a certificate of creditable coverage, or a final pay stub showing the deduction ended. Keep your Texas Workforce Commission unemployment determination letter as income evidence for your projected 2026 income. If your employer will not supply documents, you can submit a signed statement explaining the loss of coverage, but expect the application to stay pending longer. Upload before Day 60.
What state-specific rules apply after a job loss in Texas?
Texas has three state rules that matter. First, Texas did not expand Medicaid, so adult Medicaid is category-based. Second, Texas CHIP covers children under 19 up to 201% FPL year-round ($66,330 for a family of 4 in 2026). Third, Texas state continuation under Insurance Code Chapter 1251 applies to insured group policies: you need three consecutive months of prior coverage, a written request within 60 days, and coverage lasts up to nine months, or six months after COBRA. Self-funded employer plans are generally outside state law. Texas uses healthcare.gov because it has no state Exchange.
Do I qualify for Texas Medicaid or CHIP for my children after a job loss?
Your children may qualify even when you do not. Texas CHIP covers children under 19 in households up to 201% FPL, which is $66,330 for a family of 4 in 2026, and children's Medicaid covers lower-income households. Enrollment is year-round at YourTexasBenefits.com, and families above about 151% FPL pay an enrollment fee. Parent eligibility does not matter for the children. Many Texas families mix a Marketplace plan with premium tax credits for adults and CHIP or Medicaid for kids. Use the household-size table on this page to compare your family size to the 100% and 400% FPL lines.
What happens if I miss the 60-day SEP after losing my Texas job?
Missing the 60-day window means you generally cannot enroll in a Marketplace plan until the next Open Enrollment Period, which begins November 1, 2026 for 2027 coverage (confirm the closing date at healthcare.gov). Coverage would start January 1, 2027, leaving a gap with no protection against medical bills. Exceptions exist for a second qualifying life event, such as marriage, birth, or a move, or for proven delays caused by exceptional circumstances. Texas Medicaid and CHIP remain open year-round for eligible people, and COBRA or Texas state continuation may still be available if you elected on time.
