Texas · Licensed, NPN 21388659

Health insurance in Texas when you don't get a subsidy

Texas approved the steepest increase of any state I serve — 34.7% before subsidies — in the state that already had the highest uninsured rate in the country.

Texas at a glance

Rate change2026: +34.7% approved · 2027 filings not yet published
Uninsured rateHighest in the nation
Where you enrollhealthcare.gov
MedicaidNot expanded — largest coverage gap in the U.S.
Short-term plans36 months under state law — see the federal note below

Rate figures are approved 2026 plan year changes unless marked proposed. Proposed 2027 rates are carrier filings still under regulatory review — most states finalise in September and October, and approved rates routinely differ from filings. Ask me to confirm the current position for your county before you decide anything on these.

Texas had the hardest 2026 of the five states I get asked about most, and it started from the worst position.

A 34.7% increase on an already-strained market

Approved 2026 rate changes in Texas average 34.7% before subsidies. For enrollees who kept a subsidy, the average net premium still rose from roughly $57 a month in 2025 to about $89 in 2026 — a 56% increase in what people actually pay, even with credits applied.

Texas already had the highest uninsured rate in the nation: 16.7% in 2024, more than double the national figure of 8.0%. The subsidy expiration is widely expected to push that higher, though published projections vary and none is settled.

Texas uses healthcare.gov

Texas is on the federal platform. Benchmark premiums rose roughly 30% across healthcare.gov states against about 17% in states running their own exchanges — and Texas came in above even that federal average.

No Medicaid expansion, and the gap is large

Texas has not expanded Medicaid. Adults under 100% of the federal poverty level generally receive neither Marketplace subsidies nor Texas Medicaid. Combined with the state's size, that produces the largest coverage-gap population in the country. If your income is low, this is the first thing to sort out.

Short-term plans in Texas: long durations allowed, rarely sold

Texas statute permits initial terms of under 12 months and total duration, including renewals, of up to 36 months. What's available in practice is narrower: as of early 2026 at least one insurer was writing 12-month short-term policies in Texas, while most products on the market were still capped around three or four months.

So the statute is permissive and the shelf is thinner than the statute allows. Worth knowing before you assume a long bridge is available.

What the federal rule actually says. The 2024 federal rule defining short-term, limited-duration insurance caps the initial term at three months and total duration at four months including renewals. That rule has not been repealed or struck down. On August 7, 2025 the Departments of Labor, Health and Human Services and the Treasury said they do not intend to prioritise enforcing it, and signalled new rulemaking. The longer durations described above rest on that discretionary non-enforcement position together with state law — not on a change to the federal definition. It can be revisited, so ask me where it stands before you plan around a long term.

What these plans are, stated plainly. Short-term plans are medically underwritten — the application asks about your health history, and coverage can be declined, limited, or priced based on what it says. They are not ACA-compliant: pre-existing conditions may be excluded, and the essential health benefits guaranteed on every Marketplace plan are not automatic. If anyone in the household is managing a condition, an ACA plan’s guaranteed coverage is usually worth the premium difference, and I’ll tell you so even though it’s the less profitable answer for me.

Where the cliff sits

Premium tax credits end above $63,840 for one person and $132,000 for a household of four in 2027. Above that line the credit is zero, and in Texas you're paying a premium that just rose almost 35%. That combination is why so many self-employed Texans went shopping this year for the first time in a decade.

Above that line it's worth comparing everything available in Texas, not only what the exchange lists. Network breadth matters more here than in most states, because specialists can be a long drive away.

Verify me before you call

The Texas Department of Insurance maintains a public agent lookup, and my NPN is 21388659. Check it. In a market this stressed, Texas has seen its share of people selling coverage they shouldn't be.

How this works

  1. A 20-minute call. Household, income, the doctors you want to keep, the prescriptions you take. Nothing is sold on this call.
  2. I price the whole market. Marketplace plans with any subsidy you qualify for, and everything available outside it, side by side.
  3. I check networks and formularies before recommending anything. This is where cheap plans turn expensive.
  4. You decide. I tell you what I'd choose and why — including when the answer is to stay exactly where you are.
  5. I stay on the file. Claims, billing, renewals. You call me directly for as long as you hold the policy.

What it costs you

Nothing. Brokers are paid a commission by the carrier, and it's built into the premium whether you use one or not — enroll direct and the carrier simply keeps it. The plan price is identical either way. There's a fuller explanation, along with my NPN, on the licensing page.

Questions Texas clients ask

How much are Texas health insurance premiums increasing in 2026?

Approved 2026 rate changes in Texas average 34.7% before subsidies. Even for enrollees who retained a premium tax credit, the average net premium rose from about $57 per month in 2025 to roughly $89 in 2026.

Why does Texas have the highest uninsured rate?

Texas has not expanded Medicaid, leaving adults under 100% of the federal poverty level without access to either Marketplace subsidies or Texas Medicaid. Its uninsured rate was 16.7% in 2024 against a national rate of 8.0%, and the 2026 subsidy expiration is expected to push it higher.

How long can a short-term health plan last in Texas?

Texas statute permits initial terms under 12 months and total duration including renewals of up to 36 months. In practice the market is narrower — as of early 2026 at least one insurer offered 12-month policies while most available products were capped near three or four months.

Licensed in Texas and 28 other states as Rohr Health Advisors LLC. See the full list and verify the license, or start with the situation that matches yours.

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