Losing Texas Medicaid in 2026 is harder to recover from than in most states, because Texas is one of 10 states that never expanded Medicaid under the Affordable Care Act. In expansion states, nearly any adult earning under 138% of the Federal Poverty Level qualifies. In Texas, adults without children and without a disability have no Medicaid pathway at any income, and parents qualify only below roughly 15% FPL, which is about $4,100 per year for a family of three in 2026 according to the KFF state indicator for Medicaid income limits. Your path forward therefore depends on which category you were in (child, parent or caretaker, pregnant woman, person with a disability, or person age 65 and older) and on your projected 2026 household income. This guide walks through the Texas decision tree so you can pick the right door inside your 90-day Special Enrollment Period, whether that is re-applying for Medicaid, enrolling in a Marketplace plan with premium tax credits, or moving your children to Texas CHIP.
Texas Medicaid is run by the Texas Health and Human Services Commission (HHSC), and you manage your case at YourTexasBenefits.com or by calling 2-1-1 (option 2). Texas has no state-based Marketplace, so every Texan who loses Medicaid applies for private coverage at the federal site, healthcare.gov. In 2026 the enhanced premium tax credits from the American Rescue Plan Act and the Inflation Reduction Act expired on January 1, so subsidies are smaller than in 2023 through 2025 and the 400% FPL cliff is back. A second wave of Medicaid losses began October 1, 2026, when Public Law 119-21 (the 2025 reconciliation law) limited Medicaid and CHIP eligibility to citizens, lawful permanent residents, Cuban and Haitian entrants, and COFA migrants, which removes many refugees and asylees without green cards. Whatever the reason on your notice, the 90-day clock runs from the termination date, so open the notice today and write that date down.
6 Steps to Get Coverage
Common Mistakes That Cost People Thousands
Texans who lose Medicaid in 2026 most often lose coverage a second time through these errors:
- Counting the 90 days from the day you read the notice. The Marketplace SEP is counted from the Medicaid end date printed on the HHSC notice, so a letter that arrives late can leave you with fewer than 90 days.
- Applying at healthcare.gov with income under 100% FPL ($15,960 for one person in 2026) and expecting a Medicaid referral. Texas did not expand Medicaid, so the site denies premium tax credits at that income rather than sending you to expansion Medicaid.
- Waiting for a fair hearing decision before enrolling in a Marketplace plan. Texas generally does not keep paying benefits during an appeal after termination, and appeals can take weeks, so file the appeal and enroll in the same week.
- Skipping Texas CHIP for the kids. Children can enroll in CHIP or Medicaid year-round at YourTexasBenefits.com at household incomes up to about 201% FPL ($66,330 for a family of four in 2026), which is almost always cheaper than adding a child to a Marketplace plan.
- Buying a short-term plan instead of an ACA plan. Short-term plans in Texas can deny pre-existing conditions, carry no premium tax credit, and do not count as minimum essential coverage.
Who Qualifies for Texas Medicaid in 2026 and Who Falls in the Coverage Gap
Texas Medicaid in 2026 covers specific groups rather than all low-income adults, because Texas is one of the 10 non-expansion states (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming) tracked by KFF. Children qualify at higher income levels than adults, and Texas CHIP extends children's coverage to roughly 201% FPL in 2026. Pregnant women qualify at roughly 198% FPL in 2026. Parents and caretaker relatives qualify only below about 15% FPL in 2026, one of the lowest parent limits in the country. Adults with disabilities and adults 65 and older qualify through separate income and resource rules. Adults age 19 to 64 without children and without a disability are not covered at any income, which is why Texas has one of the largest coverage gaps in the country, per KFF. Texas HHSC lists the exact dollar limits for each category on its Medicaid and CHIP pages, so confirm your own number there before assuming you no longer qualify. Texas Medicaid also reviews eligibility category by category, so a change in income or household size can move you from one group to another.
The Texas coverage gap affects adults whose income is under 100% FPL ($15,960 for one person in 2026) but who do not fit a Medicaid category. Premium tax credits begin at 100% FPL, so these Texans can get neither Medicaid nor subsidies. Federally Qualified Health Centers, county hospital district financial assistance programs, and emergency Medicaid are the practical safety net in 2026. If your 2026 income later rises to at least 100% FPL, report the change at healthcare.gov, because that can unlock a subsidy or a new Special Enrollment Period. Texans losing Medicaid on October 1, 2026 solely because of the new immigration-status rules should also ask HHSC about Refugee Medical Assistance, which may cover refugees and asylees who no longer qualify for Medicaid or CHIP. Medicaid.gov confirms that Medicaid applications can be filed in any month, so re-checking your eligibility costs nothing even while you pursue a Marketplace plan.
Documents You Need After Losing Texas Medicaid in 2026
Each document on the Texas checklist proves one specific fact in 2026. The HHSC termination notice proves the qualifying life event and sets the date that starts your 90-day Marketplace Special Enrollment Period. Pay stubs, a 2025 tax return, or an unemployment award letter let healthcare.gov estimate your projected 2026 income, which determines your premium tax credit and whether you land in the coverage gap. Social Security numbers and immigration documents are needed for everyone applying, and since October 1, 2026, immigration category decides Medicaid and CHIP eligibility for non-citizens. Birth certificates support children's CHIP applications. Gather these before you start, because healthcare.gov can ask for proof within 30 days of plan selection. Each of these items is also what a Texas navigator or HHSC caseworker will ask for first, so a single folder with copies speeds up every application you file during the 90-day window. Missing any one of them is the most common reason applications stall.
Medicaid vs Marketplace vs COBRA in Texas: How to Choose in 2026
Texas Medicaid wins whenever you re-qualify, because Medicaid has no premium and no deductible, and Texas lets you re-apply at any time of year. Marketplace coverage is the default for Texas adults between 100% and 400% FPL in 2026, and Silver plans at 100% to 250% FPL add cost-sharing reductions that cut deductibles sharply. COBRA matters only for Texans who lost an employer plan at the same time as Medicaid, and at 102% of the full premium it rarely beats a subsidized Marketplace plan. Texas CHIP is the first stop for any child in the household, regardless of what the adults choose, since children can be covered even when parents are in the coverage gap. Texans who are unsure can run the free screener on this site or call the Marketplace Call Center at 1-800-318-2596 to compare options by ZIP code before choosing, and certified navigators across Texas offer free help with the healthcare.gov application.
Frequently Asked Questions
What is the Special Enrollment Period after losing Medicaid in Texas in 2026?
Texans who lose Medicaid or CHIP in 2026 can enroll in a Marketplace plan at healthcare.gov starting 60 days before the coverage ends and up to 90 days after it ends, according to KFF's Marketplace enrollment periods FAQ and CMS special enrollment guidance. For example, if Texas Medicaid ends November 30, 2026, your window runs October 1, 2026 through February 28, 2027. Select 'lost Medicaid or CHIP' as your qualifying life event and use the end date on your HHSC notice. Applying before the end date can prevent a gap in coverage.
How do I document losing Medicaid in Texas for a Marketplace application?
Keep your Texas HHSC termination notice or the letter in your YourTexasBenefits.com account, because it shows the end date and is accepted as proof of the qualifying life event. Healthcare.gov may ask you to upload it within 30 days of selecting a plan. Also have Social Security numbers, recent pay stubs or a 2025 tax return for projected 2026 income, and your Texas ZIP code ready. If you cannot find the notice, call 2-1-1 (option 2) or Your Texas Benefits at 1-877-541-7905 and request a copy before your window closes.
What if I miss the 90-day window after losing Texas Medicaid?
Missing the window generally means waiting for Open Enrollment, which runs November 1, 2026 through January 15, 2027 for coverage that starts in 2027, so coverage could begin as late as February 1, 2027. A new qualifying life event, such as a move to a new coverage area, marriage, birth, or loss of employer coverage, opens a fresh Special Enrollment Period. Children can enroll in Texas CHIP or Medicaid at YourTexasBenefits.com at any time of year, and you can re-apply for Texas Medicaid year-round if you re-qualify.
Can I get retroactive coverage after losing Texas Medicaid?
Marketplace coverage after a Medicaid loss starts on the first day of the month after you select a plan, and it is not retroactive to the Medicaid end date, so a gap can occur if you wait. Selecting a plan before your Medicaid ends can make coverage start the first of the following month with no gap. If you win a Texas fair hearing, HHSC may restore Medicaid back to the termination date, and you could then cancel the Marketplace plan.
What is the difference between COBRA and the Marketplace after losing Medicaid in Texas?
COBRA only exists if you also lost an employer plan, because Medicaid is not employer coverage. COBRA lets you keep the employer plan for 18 to 36 months but charges 102% of the full premium, about $400 to $900 per month for one person in 2026, with a 60-day election window. A Marketplace plan at healthcare.gov can cost far less after premium tax credits for incomes between 100% and 400% FPL ($15,960 to $63,840 for one person in 2026). COBRA makes sense mainly when you need to keep a specific doctor or a met deductible.
What Texas-specific rules apply after losing Medicaid in 2026?
Texas has not expanded Medicaid, so only specific groups qualify: children, pregnant women, parents below roughly 15% FPL in 2026, people with disabilities, and adults 65 and older. Texas has no state-based Marketplace, so you apply at healthcare.gov. Texas CHIP covers children up to roughly 201% FPL in 2026. Since October 1, 2026, federal law limits Medicaid and CHIP for non-citizens to lawful permanent residents, Cuban and Haitian entrants, and COFA migrants, so refugees and asylees without green cards lost eligibility. Ask HHSC about Refugee Medical Assistance if that is your situation.
Do I qualify for Medicaid again after losing it in Texas?
Texas Medicaid is open year-round, so you can re-apply at YourTexasBenefits.com the day you lose coverage. You qualify again if you are a child, a pregnant woman, a parent or caretaker with income below roughly 15% FPL in 2026 (about $4,100 per year for a family of three), a person with a qualifying disability, or an adult 65 or older within income and resource limits. A non-parent adult with no disability does not qualify at any income in 2026. Use the household-size table on this page, then check Marketplace subsidies if you are above 100% FPL.
What happens to my children's coverage if I lose Texas Medicaid?
Your children's eligibility is judged separately from yours. Texas Medicaid covers children at lower household incomes, and Texas CHIP covers children in families up to roughly 201% FPL in 2026, which is about $66,330 for a family of four. Apply at YourTexasBenefits.com or call 2-1-1 (option 2); applications are accepted year-round with no Special Enrollment Period deadline. If your child no longer qualifies because of immigration status after October 1, 2026, a Marketplace plan with premium tax credits may still be available, so compare both before the 90-day window closes.
