Texas Health Insurance 2026
Health insurance in Texas is sold through Federal (Healthcare.gov), with an estimated 150-250 plans available for 2026. The average Silver-tier premium is $480/mo before subsidies for a 40-year-old non-smoker. Medicaid status: Not expanded.
Marketplace
Federal HC.gov
Federal (Healthcare.gov)
Avg Silver Premium
$480/mo
Before tax credits, age 40
Medicaid
Not expanded
Affordable Care Act status
Texas 2026 Health Insurance Quick Facts
| Field | Value | Notes |
|---|---|---|
| Marketplace | Federal (Healthcare.gov) | Apply via Healthcare.gov |
| Open Enrollment 2026 | Nov 1, 2026 – Jan 15, 2027 | Special enrollment for QLEs year-round |
| Plans available | 150-250 | Bronze/Silver/Gold/Platinum tiers |
| Medicaid expansion | Not expanded | Coverage gap may exist |
Premium and plan counts are estimates for 2026 based on prior-year filings and pending rate approvals. Always verify pricing on the marketplace itself before enrolling.
Texas: Massive Marketplace Enrollment Despite Being the Largest Non-Expansion State
Texas has a large and growing ACA marketplace, with 150–250 plans statewide, reflecting its enormous population and geographic diversity. BCBS Texas, Ambetter, and Cigna are the leading carriers, with significant competition in Houston, Dallas-Fort Worth, Austin, and San Antonio metros. Silver premiums average $470–$495/month for a 40-year-old before subsidies. Rural West Texas and the Rio Grande Valley have much thinner markets with limited carrier and network options. Despite its political resistance to the ACA, Texas has consistently ranked among the top states for marketplace enrollment in absolute numbers.
Texas has the highest number of uninsured residents of any state — over 5 million — and the highest uninsured rate among large states, driven by both Medicaid non-expansion and a large low-income immigrant population ineligible for federal coverage. The state's Medicaid program (STAR) covers primarily children and severely disabled individuals. An estimated 1.5 million Texans fall in the coverage gap. Texas uses Healthcare.gov for marketplace enrollment and has no state subsidies or reinsurance programs. Political resistance to the ACA remains strong in the legislature, though practical benefits of federal subsidies have made the marketplace popular with consumers.
What to Know About Health Insurance in Texas
Top marketplace carriers
Leading 2026 ACA carriers in Texas: Blue Cross Blue Shield of Texas, Ambetter (Centene), Cigna. Plan selection and network breadth vary widely by ZIP code — use the marketplace's plan-finder tool with your ZIP and household income for accurate availability.
Notable state rule
Texas has the highest number of uninsured residents of any state (over 5 million), the highest uninsured rate among large states, and is the largest non-expansion state by population.
Medicaid eligibility
Texas has not expanded Medicaid. This creates a "coverage gap" where some adults earn too much for Medicaid but too little to qualify for premium tax credits. Check eligibility for traditional Medicaid (parents, pregnant women, disabled, elderly) separately.
Texas Pro Tip
Health Insurance FAQs — Texas
Who runs the health insurance marketplace in Texas?
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Texas uses the federal marketplace at Healthcare.gov. The state does not operate its own exchange.
How much does Silver-tier health insurance cost in Texas before subsidies?
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A 40-year-old non-smoker in Texas typically pays about $470–$495/month for a Silver plan before subsidies, with significant variation by region.
Is Medicaid expanded in Texas?
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No. Texas has not expanded Medicaid under the ACA. Texas Medicaid covers primarily children and specific disabled populations, leaving over 1.5 million adults in the coverage gap.
Related Guides
Marketplace data sourced from state and federal exchange filings for Texas, April 2026. Premium estimates are 2026-projected.
Jennifer Walsh
Editorial Lead, Health & Medicare
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed April 2026
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