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 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%. Projections tied to the subsidy expiration have that climbing toward 20%, with Marketplace enrollment falling by as much as 1.45 million people and up to 800,000 Texans becoming uninsured.

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.

Where the cliff sits

Premium tax credits end above $62,600 for one person and $128,600 for a household of four in 2026. 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.

For a healthy household above the threshold, a non-Marketplace PPO frequently costs meaningfully less, with wider access than the narrow networks common on Texas exchange plans — which matters in a state where specialists may 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 I work, and what it costs

A 20-minute call: household, income, health history, the doctors and prescriptions you can't lose. Then I price the unsubsidized Marketplace option against whatever non-Marketplace options exist in your state, verify networks and formularies before recommending anything, and tell you which I'd choose and why.

It costs you nothing. Brokers are paid a commission by the carrier, built into the premium whether you use one or not — enroll direct and the carrier simply keeps it. There's a fuller explanation, plus my NPN, on the licensing page.

One thing worth being direct about: the non-Marketplace plans I work with are medically underwritten and not ACA-compliant. The application asks about your health history, coverage can be declined or limited based on it, and pre-existing conditions may be excluded. In exchange you get a lower premium, a real maximum out-of-pocket, and usually a broader network. If you're managing an ongoing condition, an ACA plan's guaranteed coverage is often worth more than the premium difference — and I'll tell you that even though it's the less profitable answer for me.

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 projections tied to the 2026 subsidy expiration put it near 20%.

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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