The Texas Health Insurance Marketplace operates as a federally-facilitated exchange through HealthCare.gov, where residents can enroll in ACA-compliant individual and family health plans.2 For 2026, there are 16 participating insurers offering coverage across Texas, with coverage areas varying by provider; most regions have multiple insurer options, though some north-central counties have only one available insurer.2 One new insurer, Harbor Health, joined the marketplace for 2026, while Aetna exited the market at the end of 2025.2

Premiums for 2026 have seen significant increases, with the highest increase at 42.57% for Cigna and 41.48% for Celtic/Ambetter.2 Texas requires insurers to add a 40% load to Silver plan premiums to account for cost-sharing reductions (CSR), which makes Silver plans more expensive than many Gold plans and results in larger subsidies for Bronze and Gold plans.2 As a result, Gold plans may offer better value for some consumers, especially those not eligible for CSR.2

To qualify for coverage, applicants must live in Texas, be lawfully present in the U.S., not be incarcerated, and not be enrolled in Medicare.2 Financial assistance, including advance premium tax credits and cost-sharing reductions, is available based on income and household size.2 For 2025, 95% of enrollees received premium subsidies, reducing the average net premium to about $57 per month.2 However, Texas has not expanded Medicaid, leaving an estimated 570,000 individuals in a coverage gap due to income levels below the poverty level.2

Enrollment for 2026 coverage is open from November 1 to January 15, with coverage starting on January 1 if applications are submitted by December 15.2 Applications can be completed online at HealthCare.gov, through licensed agents or brokers, Navigators, certified application counselors, or enhanced direct enrollment entities.2 Assistance is also available via phone at 1-800-318-2596 (TTY: 1-855-889-4325).2 For those seeking in-person help, community resources such as Carevide, Eligibility Consultants, Inc., and various clinic-based programs offer application support.2

Blue Cross Blue Shield of Texas (BCBS TX) is noted for having a broad statewide network and is often recommended for its extensive provider access.3 Other insurers include Celtic/Ambetter, Superior Health Plan/Ambetter, UnitedHealthcare, Cigna, Moda, Molina, Oscar, and Baylor Scott & White Health Plan.3 Consumers are advised to verify that their preferred doctors and medications are covered under a plan’s provider network and formulary.3