Average Cost of Health Insurance in Texas (2026)
What Texans are actually paying for ACA Marketplace coverage, and how premium tax credits change the math.
2026 premium snapshot
Figures are statewide averages and vary significantly by county, age, tobacco use, and plan metal tier. Always compare exact quotes for your ZIP code.
Why premiums are rising
Insurers cited rising medical costs, prescription drug prices, and the scheduled expiration of enhanced federal premium tax credits as the main drivers behind 2026 rate increases in Texas. Because Texas has a large number of Marketplace enrollees relying on subsidies, changes to federal tax credit policy have an outsized effect on what Texans pay out of pocket compared to expansion states.
Premium tax credits (subsidies)
Most people who enroll through the ACA Marketplace in Texas qualify for a premium tax credit that reduces their monthly cost, based on household income and family size. The credit is applied directly to your monthly premium, so the "sticker price" of a plan is often not what you'll actually pay. It's worth getting a personalized quote before assuming coverage is unaffordable.
The Texas coverage gap
Texas has not expanded Medicaid, so adults under 65 without children and without a disability generally cannot qualify for Medicaid no matter how low their income is — and if their income is too low, they may also fall below the threshold required for Marketplace tax credits. This leaves an estimated 570,000– 617,000 Texans in a coverage gap: too much income for Medicaid, too little for subsidized Marketplace coverage. Texas accounts for roughly 42% of everyone in this gap nationwide. If this applies to you, a licensed agent can help you check for community health center programs, employer options, or short-term coverage.
Ways to lower your cost
- Get your exact subsidy amount before comparing sticker prices — many people qualify for more than they expect.
- Compare Bronze vs. Silver plans carefully: Silver plans can unlock additional cost-sharing reductions if your income qualifies.
- Check whether your preferred doctors are in-network for an HMO before assuming a pricier PPO is necessary.
- Review your plan every open enrollment — carriers change pricing and networks in Texas every year.
See what you'd actually pay
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