Texas Health Insurance Guide

Health Insurance Overview in Texas

Texas has not expanded Medicaid and has the highest uninsured rate of any state in the nation — approximately 17-18% of Texans lack health insurance. Texas uses the federal HealthCare.gov marketplace, which has very high enrollment (over 3 million) despite the state's non-participation in expansion. Texas's marketplace is highly competitive in its major metro areas.

Average Health Insurance Costs in Texas

Health insurance premiums in Texas vary significantly based on age, plan type (Bronze, Silver, Gold, Platinum), insurer, and income-based subsidies. The figures below represent estimated 2026 benchmark premiums before ACA subsidies for a 40-year-old individual and family of four.

Coverage Type	Monthly Premium	Annual Premium
Individual (benchmark Silver)	$472/mo	$5664/yr
Family of Four (benchmark Silver)	$1,352/mo	$16224/yr
Avg. Annual Deductible	$5,000

Premiums shown are before ACA subsidies. Most marketplace enrollees receive premium tax credits that significantly reduce these costs. Use our Health Insurance Calculator to estimate your net premium after subsidies.

Marketplace Enrollment in Texas

Texas residents can enroll in individual and family health insurance plans through HealthCare.gov (Federal). Open enrollment runs November 1 – January 15 (federal marketplace). Outside of open enrollment, a qualifying life event (job loss, marriage, birth of a child, move to a new state) triggers a Special Enrollment Period during which you can enroll or change plans.

Average Premiums by City in Texas

Health insurance premiums vary by location within Texas, reflecting local healthcare costs, provider availability, and insurer competition. The following estimated monthly individual premiums are based on a benchmark Silver plan for a 40-year-old non-smoker.

City	Est. Monthly Premium (Silver, age 40)
Houston	$488/mo
San Antonio	$468/mo
Dallas	$482/mo
Austin	$472/mo
Fort Worth	$478/mo
El Paso	$452/mo
Arlington	$475/mo
Corpus Christi	$458/mo

Medicaid in Texas

Texas has not expanded Medicaid. Traditional Medicaid (STAR program) covers very limited categories: children, pregnant women, the elderly, and people with disabilities. Adults without children generally do not qualify, leaving millions in the coverage gap.

Children's Health Insurance (CHIP) in Texas

CHIP covers children under 19 in families with incomes up to 201% of the federal poverty level.

What Makes Texas Unique

Texas has the largest uninsured population and highest uninsured rate in the nation. Despite this, Texas has among the highest marketplace enrollment in the nation due to its large population. The combination of the largest marketplace enrollment and the largest uninsured population illustrates both the marketplace's reach and the limits of marketplace coverage without Medicaid expansion.

ACA Subsidies: What Texas Residents Should Know

Premium tax credits (subsidies) are available for Texas residents who purchase coverage through the marketplace and have incomes between 100% and 400% of the federal poverty level (or higher in states with additional state subsidies). The subsidy amount is based on the cost of the benchmark Silver plan in your area and your income. For 2026, the enhanced subsidies first enacted in the American Rescue Plan have been extended, providing more substantial assistance across a broader income range than before.

Cost-sharing reductions (CSRs) provide additional savings on deductibles and copays for those who enroll in Silver plans with incomes between 100-250% of the federal poverty level. Silver plans with CSRs often provide Gold or Platinum-level value at Silver premiums, making them the best value for eligible enrollees.

Tips for Choosing Health Insurance in Texas

Texas residents earning 100%+ of the federal poverty level should check HealthCare.gov for subsidy eligibility — Texas metro areas have strong marketplace competition. CHIP covers children. Adults below the poverty level have very limited options. Texas's large community health center network serves uninsured patients on a sliding fee scale.

• Enroll during open enrollment (November 1 – January 15 (federal marketplace)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.
• Check both Medicaid eligibility and marketplace subsidy eligibility — your income determines which program you qualify for.
• Don't just compare premiums — also compare deductibles, out-of-pocket maximums, and whether your doctors are in-network.
• Silver plans with cost-sharing reductions (for incomes 100-250% FPL) typically offer the best overall value despite higher premiums than Bronze plans.
• Use our Health Insurance Calculator to estimate your total annual cost (premium + expected out-of-pocket) for different plan options.

The information on this page is provided for general informational purposes only and reflects estimated industry averages and program eligibility rules as of 2026. Health insurance premiums, Medicaid eligibility thresholds, marketplace options, and program rules change annually. Always verify current eligibility and enrollment options at the official HealthCare.gov (Federal) or by contacting a certified navigator or broker. Premium figures shown are approximations before subsidies — actual net premiums depend on individual income, household size, and plan selection.