Moving to Texas in 2026 means navigating one of the most distinctive health coverage landscapes in the country. Texas is one of 10 states that has not expanded Medicaid under the ACA, and it uses the federal marketplace at healthcare.gov rather than a state-run exchange. These two facts shape every decision you make in your first 60 days. A healthy adult earning $30,000 a year who moves from an expansion state like California or New York to Texas loses Medicaid eligibility the moment they cross state lines, because Texas Medicaid is restricted to specific groups: pregnant women, children and teens, people with disabilities, and very-low-income parents with dependent children. Medicaid income limits for parents in Texas are among the lowest in the nation; a working parent of two can earn as little as $3,737 a year and still not qualify. For most Texas newcomers, the ACA Marketplace at healthcare.gov is the primary coverage pathway, and the 60-day Special Enrollment Period that moving triggers is the gateway to affordable 2026 plans. Texas has historically had the highest uninsured rate of any state; about 17% of the population, per KFF 2024 data. Understanding Texas's rules before Day 60 expires is the single most important thing you can do for your health and finances.
Three things newcomers to Texas must know before Day 60. First: your old marketplace plan from another state does not work in Texas. Marketplace plans are licensed and sold by state; a Gold plan from Covered California or NY State of Health has zero Texas providers in its network. Second: Medicaid does not follow you. You must check Texas Medicaid eligibility rules from scratch at hhs.texas.gov, and unless you are pregnant, a child, or qualify on disability grounds, you almost certainly will not qualify. Third: Texas CHIP covers children in households up to 201% FPL at very low cost, and CHIP enrollment is year-round even when Medicaid is not available. The qualified life event of moving to Texas is your entry point for healthcare.gov enrollment, and the steps below walk you through how to use that 60-day window efficiently. For income context, check the ACA income limits at /aca-income-limits and the federal poverty level table at /federal-poverty-level to see exactly where your household income falls relative to the subsidy thresholds.
7 Steps to Get Coverage
Common Mistakes That Cost People Thousands
The most expensive mistakes newcomers to Texas make with health insurance after their move:
- Assuming Texas expanded Medicaid. Texas has NOT expanded Medicaid. Unlike the 40 states plus DC that cover adults at 138% FPL, Texas covers very few non-elderly, non-pregnant, non-disabled adults. Do not assume your low income qualifies you; check the Texas HHSC eligibility rules at hhs.texas.gov first.
- Trying to enroll on a state exchange website for Texas. Texas uses the federal marketplace at healthcare.gov; there is no separate Texas exchange website. Searching for 'Texas health insurance exchange' and landing on a broker or non-official site can lead to enrollment in non-ACA-compliant plans that do not count as minimum essential coverage.
- Missing the prior-coverage requirement for the move SEP. The 60-day SEP for moving to Texas requires that you had minimum essential coverage for at least one of the 60 days before your move date. People who were uninsured before moving to Texas do not qualify for the move-triggered SEP and must wait until November Open Enrollment.
- Waiting past Day 60 to compare plans. Most people who miss the 60-day SEP do so because they intended to enroll soon but kept delaying. Texas has the highest uninsured rate in the US; being uninsured here is a serious financial risk. One ER visit in a Texas hospital averages $3,000 to $12,000 without coverage.
- Forgetting to cancel old state marketplace coverage after enrolling in Texas. Keeping both plans active creates a double-subsidy problem that triggers IRS reconciliation on Form 8962 when you file your 2026 taxes. Cancel the old plan effective your move date and document the cancellation confirmation.
- Not checking CHIP for children separately. Even if you do not qualify for Texas Medicaid and cannot afford marketplace premiums, your children may qualify for Texas CHIP at incomes up to 201% FPL ($43,500 for a family of 2 in 2026). CHIP enrollment is year-round and does not depend on your SEP window.
Texas Medicaid in 2026: What Non-Expansion Means for You
Texas Medicaid (administered by the Texas Health and Human Services Commission, HHSC) is one of the most restrictive Medicaid programs in the country. Texas is among the 10 states that did not expand Medicaid under the ACA, alongside Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Wisconsin, and Wyoming. Expansion states opened Medicaid to any adult at or below 138% FPL; in 2026 that means $22,025 for a single person or $45,540 for a family of 4 in those states. Texas never adopted that expansion. If you moved from an expansion state like California, Illinois, or Virginia to Texas, your Medicaid coverage terminated when you left your old state, and Texas will not replace it unless you fall into a covered eligibility category.
Texas Medicaid covers four main groups. Pregnant women are eligible at incomes up to 201% FPL for pregnancy-related services, with postpartum coverage extending 12 months after delivery. Children and teens under 19 are covered at incomes up to 201% FPL through the Texas CHIP program; CHIP enrollment is year-round and premiums are $0 to $50 per month depending on income. Parents and caretaker relatives of minor children qualify only at very low income thresholds; the income limit for a working parent of two is often below 20% FPL, which translates to roughly $3,700 per year for a household of 3. People with disabilities who receive SSI automatically qualify. If you do not fit one of these four groups, Texas Medicaid is unavailable regardless of how low your income is. The ACA Marketplace at healthcare.gov is your coverage path. See the ACA income limits page for the full subsidy schedule.
ACA Marketplace Plans in Texas: What to Expect in 2026
Texas enrolls through healthcare.gov, the federally facilitated marketplace. Texas is the largest state by marketplace enrollment, with roughly 3.6 million Texans enrolled in ACA plans for 2025 (CMS data). In 2026, Texas marketplace plans are offered by Blue Cross Blue Shield of Texas, Molina Healthcare, Oscar Health, Bright Health (in select markets), and Community Health Choice in Houston. The range of available plans varies significantly by Texas ZIP code. Dallas, Houston, Austin, and San Antonio have broad plan offerings from multiple carriers. Rural and West Texas ZIP codes may have only 1 to 2 carriers, limiting competition and network options.
Silver plans are the anchor plan level on the Texas marketplace. Silver plans receive the largest premium tax credits and, for households under 250% FPL ($39,900 single in 2026), also qualify for cost-sharing reductions (CSR) that can lower your deductible from $4,000 to $800 or less. The 2026 ACA out-of-pocket maximum is $10,600 for individual plans and $21,200 for family coverage. At lower incomes near 100% FPL ($15,960 single), some Silver plans cost $0 after tax credits. At 200% FPL ($31,920 single), the benchmark Silver plan typically runs $50 to $150 per month after credits in major Texas markets. Always compare total cost: premium plus deductible plus expected copays, not just monthly premium.
Texas CHIP: Year-Round Coverage for Children Regardless of Your SEP Status
Texas CHIP (Children's Health Insurance Program) is distinct from Medicaid and is available to uninsured children under 19 in families at 0% to 201% FPL year-round. Texas CHIP is not affected by the state's non-expansion Medicaid status; Congress funds CHIP separately and it covers children in non-expansion states with the same comprehensive benefit package as Medicaid expansion states. In 2026, 201% FPL for a family of 3 is approximately $54,910 and for a family of 4 is approximately $66,330. Premiums for Texas CHIP range from $0 for the lowest-income families to approximately $50 per month for higher-income CHIP-eligible families. Benefits include preventive care, immunizations, dental, vision, mental health care, and prescription drugs.
Apply for Texas CHIP through hhs.texas.gov or healthcare.gov at any time. The 60-day Marketplace SEP does not affect CHIP enrollment; your children can be enrolled in CHIP even after the SEP window closes for adult marketplace plans. If you enroll children in Texas CHIP and you separately enroll in a marketplace plan for yourself, you can have different coverage for different household members. This split-enrollment approach is allowed and common for households where children qualify for CHIP but adults must use the marketplace.
Frequently Asked Questions
Does moving to Texas trigger a Special Enrollment Period for health insurance?
Yes. Permanently moving to Texas triggers a 60-day Special Enrollment Period for ACA Marketplace plans at healthcare.gov. The requirement is that you had minimum essential coverage for at least one of the 60 days before your move date. Your 60-day clock starts on the date you moved to Texas. For example, moving on June 1, 2026 gives you until July 31, 2026 to enroll in a new Texas plan. Texas uses the federal marketplace at healthcare.gov rather than a separate state exchange, so all 2026 plan shopping and enrollment happens at healthcare.gov when you report your move as the qualifying life event.
Does Texas have expanded Medicaid in 2026?
No. Texas has not expanded Medicaid under the ACA and as of 2026 shows no signs of doing so. Texas Medicaid (administered by HHSC) is available only to pregnant women (up to 201% FPL), children under 19 via CHIP (up to 201% FPL), parents and caretaker relatives of minor children at very low income thresholds often under 20% FPL, and people with disabilities receiving SSI. A healthy single adult or childless couple who moved to Texas from a Medicaid expansion state like California or New York loses Medicaid eligibility on moving day and cannot replace it through Texas Medicaid at any income level.
What documents do I need to prove my move to Texas for the SEP?
Healthcare.gov requires proof of the move to Texas for the Special Enrollment Period. Acceptable documents include a signed lease agreement or mortgage closing statement with your Texas address, a utility bill (electric, gas, water) at your new Texas address, a Texas driver's license or vehicle registration with your new address, or government mail addressed to you at your new Texas address. Have at least one of these documents ready before you start the enrollment process. Healthcare.gov typically gives you a window to upload documentation after you select a plan.
What if I moved to Texas but was uninsured before the move?
The move-triggered SEP requires prior coverage. If you had no minimum essential coverage in any of the 60 days before your Texas move date, you do not qualify for the move SEP at healthcare.gov. Your options are limited: (1) apply for Texas Medicaid if you fall into an eligible category (pregnant, child, disabled, very-low-income parent), (2) check Texas CHIP for your children (year-round, no prior-coverage requirement), or (3) wait until the next Open Enrollment Period in November 2026 for 2027 marketplace coverage. In a true medical emergency, seek care at a Texas hospital; under federal EMTALA law, emergency departments cannot turn away patients regardless of coverage status.
Can I keep my old marketplace plan when I move to Texas?
No. Your old state marketplace plan is tied to your former state's coverage area. A plan from California's Covered California or New York's NY State of Health has no in-network providers in Texas and technically does not cover non-emergency services at a Texas address. You must enroll in a Texas marketplace plan at healthcare.gov using your 60-day SEP. Cancel your old plan effective your move date to avoid being charged premiums for two overlapping plans and to prevent a subsidy reconciliation issue on your 2026 Form 1095-A.
Are ACA marketplace plans affordable in Texas for 2026?
For most households, yes. At incomes near 100% FPL ($15,960 single, $33,000 family of 4 in 2026), premium tax credits typically bring Silver plan premiums to $0 to $50 per month on healthcare.gov in major Texas markets. At 200% FPL ($31,920 single), benchmark Silver plans typically run $50 to $150 per month after credits. At 400% FPL ($63,840 single), the subsidy cliff returns for 2026 and you pay full premium. The 2026 ACA out-of-pocket maximum is $10,600 per person. For cost-sharing reductions (lower deductibles), you must enroll in a Silver plan at incomes under 250% FPL.
What happens to my children's coverage when I move to Texas?
Texas CHIP covers children under 19 at incomes up to 201% FPL year-round, regardless of the state's Medicaid non-expansion status. Texas CHIP enrollment is open at any time and is separate from the 60-day marketplace SEP that applies to adults. If your children were on Medicaid in your prior state, that coverage ends when you leave; apply for Texas CHIP through hhs.texas.gov or healthcare.gov immediately after establishing Texas residency. CHIP premiums in Texas range from $0 to approximately $50 per month. Benefits include dental, vision, and mental health care.
What if I miss the 60-day SEP after moving to Texas?
If you miss the 60-day SEP window, you generally cannot enroll in a Texas marketplace plan until the next Open Enrollment Period, which runs November 1 through January 15 for 2027 coverage. Exceptions: if another qualifying life event occurs (marriage, birth, losing a job, gaining or losing Medicaid eligibility), a new 60-day SEP opens. Texas CHIP for children has no enrollment deadline. Texas Medicaid for eligible groups (pregnant women, children, disabled individuals) is year-round. Being uninsured in Texas carries real financial risk; one ER visit averages $3,000 to $12,000.
