Health insurance · Texas
ACA Marketplace Health Insurance in Texas
Texas has not expanded Medicaid: marketplace subsidies begin at $15,960 for one person in 2026, and below that there is no subsidy.
- Under 65
- healthcare.gov
- Financial assistance for those who qualify
Marketplace coverage in Texas
Texas has not expanded Medicaid, so a Texas adult earning less than $15,960 a year in 2026 — the federal poverty level for one person, $33,000 for a family of four — who does not fit a traditional Medicaid category gets neither Medicaid nor a marketplace subsidy. In a state of 254 counties that coverage gap reaches a great many people. Above the poverty level the premium tax credit applies, and Texas plans are sold on healthcare.gov.
A real person calls you back.Licensed agents in our Greenwood Village, Colorado office — not a call center, not a robot.
Where Texas residents buy marketplace coverage
Every plan sold on the marketplace covers the ten essential health benefits, none can decline you or charge more for a pre-existing condition, and the premium tax credit is applied through the same application.
healthcare.gov
Texas marketplace plans are sold through healthcare.gov. Texas has no state-run exchange; the federal marketplace handles enrollment and the premium tax credit. A licensed agent can enroll you there at no extra cost — the carrier pays us; your premium does not change. See how ACA marketplace plans work.
Medicaid expansion in Texas
Texas has not expanded Medicaid. Adult Medicaid here covers specific groups only — children, pregnant women, some parents with very low income, people with disabilities and older adults. Marketplace premium tax credits begin at 100% of the federal poverty level, which in 2026 is $15,960 for one person, $21,640 for two, $27,320 for three and $33,000 for four. An adult in Texas who earns less than that and does not fit a Medicaid category is in the coverage gap: no Medicaid and no marketplace subsidy. If that is your situation, say so on the call — the honest answer is not a quote for a plan you cannot afford. Expansion status per KFF’s Medicaid expansion tracker (as of August 2026) and medicaid.gov; income lines from the 2026 HHS poverty guidelines.
What you would actually pay, and when you can enroll
The sticker price is not what most people pay
Premium tax credits are based on your household income and household size, and they are applied directly to your monthly premium rather than paid back at tax time. We check what you qualify for before you pick a plan, so you are comparing what you would actually pay each month, and we tell you if a plan’s deductible or network makes the cheapest premium a poor choice.
Open enrollment in Texas
Open Enrollment is the annual window when anyone can sign up for a marketplace plan or change the one they have. It generally runs from November into January. Texas uses the federal marketplace, so its window follows the healthcare.gov schedule. Outside that window you need a qualifying life event — losing job coverage, moving, marriage, or a new child — to enroll. Dates are set each plan year; a licensed agent will confirm the current ones on the call.
Turning 65 in Texas?
If you are turning 65, or already have Medicare, a marketplace plan is usually the wrong product: once Part A and Part B begin, the premium tax credit ends and Medicare becomes primary. The natural next step is a Medicare Advantage plan for your county.
Texas insurance regulation
Texas Department of Insurance
Marketplace plans sold in Texas are regulated by the Texas Department of Insurance, which approves the plans and rates carriers may offer, licenses the agents who sell them and handles consumer complaints.
Common questions in Texas
I earn less than the poverty level in Texas. What can I do?
This is the Texas coverage gap. Below $15,960 for one person or $33,000 for a family of four in 2026, healthcare.gov offers no premium tax credit, and Texas Medicaid covers only specific groups because the state did not expand. Low-income parents, pregnant women, people with disabilities and adults 65 and over may still qualify for Texas Medicaid; a licensed agent will tell you honestly what exists for anyone else.
Where do Texans buy ACA marketplace coverage?
Through healthcare.gov, the federal marketplace; Texas does not run its own exchange. The application checks whether you are above the $15,960 subsidy line and calculates your premium tax credit. A licensed agent can enroll you at no extra cost.
How much will a Texas marketplace plan cost me above the poverty level?
The premium after the tax credit, set by household income and size and applied monthly. A Texas household just above $15,960 for one person or $27,320 for three receives close to the largest credit available. We calculate it first and compare plans on the net price.
I am turning 65 in Texas. Should I keep my marketplace plan?
Usually not. Once Medicare Part A and Part B begin, the premium tax credit ends and Medicare becomes primary. Texas’s Health Information, Counseling, and Advocacy Program (HICAP), run through Texas Health and Human Services at 1-800-252-9240, offers free Medicare counseling, and our agents compare the Medicare Advantage plans filed for your Texas county.
Prefer we call you? Here is what happens next.
A real person calls you back.Licensed agents in our Greenwood Village, Colorado office.
A licensed agent calls you back
During business hours: Monday to Friday 9 to 7, Saturday 9 to 5, Mountain Time.
We focus on what you actually need
Tell us whether you need help with Final Expense insurance, Medicare or another health coverage question. Your agent reviews the options that apply to your situation.
You decide what fits
We explain the important differences and next steps. If an option makes sense, we can help you move forward. There is no fee for speaking with us.
Sources
- healthcare.gov — the marketplace for Texas
- medicaid.gov — Adult Coverage Expansion map and the May 2026 Medicaid & CHIP enrollment highlights (expansion status)
- Texas Department of Insurance — state insurance regulator
- Wikimedia Commons — state outline (CC0)
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Last updated: September 2026