Texas has no state-run health insurance exchange, so every resident shopping for Marketplace coverage uses healthcare.gov. For 2026, roughly 4.2 million Texans enrolled through the federal Marketplace, and about 92% of them received a premium tax credit that lowered their monthly bill. The catch for 2026 is that the enhanced subsidies Congress added in 2021 expired at the end of 2025, so premium tax credits reverted to the original, smaller ACA formula and the income cap on subsidies (the "subsidy cliff") is back at 400% of the federal poverty level. Here's what that actually means for your premium, what income qualifies, and how to apply.
Why Texas Marketplace Costs Changed for 2026
From 2021 through 2025, temporary federal law removed the income cap on subsidies and increased the amount of help available at every income level. Congress let those enhancements expire on December 31, 2025. Starting with 2026 coverage, two things changed for Texas enrollees:
- The subsidy cliff returned. If your household income is above 400% of the federal poverty level, you no longer qualify for any premium tax credit, no matter how expensive your local benchmark plan is.
- Subsidy amounts shrank at every income tier. Even households still under 400% FPL are contributing a larger share of their income toward premiums than they did in 2025.
The practical result in Texas: the average advance premium tax credit (APTC) rose to about $667/month in 2026 (up from $541/month in 2025) because gross premiums went up, but the average net premium Texans pay out of pocket also rose, from about $57/month in 2025 to about $89/month in 2026. Many Texans responded by switching from Silver plans to cheaper Bronze plans during open enrollment to keep their monthly payment down.
Texas also adopted a state insurance rule for 2026 requiring insurers to add a 40% "load" to Silver plan pricing. Because subsidy amounts are calculated off the Silver benchmark plan, this actually increases the size of the subsidy available and can make Bronze and even Gold plans cheaper than Silver after the tax credit is applied. It's worth comparing all three metal tiers rather than assuming Silver is your best deal.
2026 Income Limits for Marketplace Subsidies
Premium tax credit eligibility for 2026 coverage is based on the 2025 federal poverty guidelines. In Texas, subsidies are available to households with income from 100% to 400% of the federal poverty level. Because Texas has not expanded Medicaid, there is no lower Medicaid cutoff pushing that floor higher, but there is a coverage gap for people under 100% FPL who don't have children or a qualifying disability (more on that below).
| Household Size | 100% FPL (Annual) | 150% FPL (Annual) | 250% FPL (Annual) | 400% FPL (Annual) |
|---|
| 1 | $15,650 | $23,475 | $39,125 | $62,600 |
| 2 | $21,150 | $31,725 | $52,875 | $84,600 |
| 3 | $26,650 | $39,975 | $66,625 | $106,600 |
| 4 | $32,150 | $48,225 | $80,375 | $128,600 |
| 5 | $37,650 | $56,475 | $94,125 | $150,600 |
Households between 100% and 250% FPL also qualify for Cost-Sharing Reductions (CSR) on Silver plans, which lower deductibles, copays, and out-of-pocket maximums on top of the premium tax credit. CSR is only available if you pick a Silver plan, so if your income falls in that range, Silver is usually worth a second look even with the 40% Texas load.
Average 2026 Premiums in Texas
Actual premiums vary by county rating area and insurer, but statewide averages give a useful starting point before subsidies are applied.
| Metal Tier | Average Gross Monthly Premium (before subsidy) | What It Covers |
|---|
| Bronze | Approximately $355 to $456 | Lowest premium, highest deductible (around $7,186 average) |
| Silver | Approximately $625 (benchmark plan) | Moderate premium and deductible (around $5,304 average); only tier with CSR |
| Gold | Typically higher than Bronze, often close to or below Silver in Texas for 2026 due to the Silver load | Lower deductible, higher monthly premium |
Your actual after-subsidy premium depends entirely on your household income relative to the benchmark Silver plan in your rating area. Two households with the same income can pay different amounts depending on their ZIP code, since the benchmark plan price varies by county.
How the Premium Tax Credit Is Calculated
The premium tax credit caps what you pay for the benchmark Silver plan at a percentage of your income, then applies that same dollar credit to whichever plan you actually choose. For 2026, the expected contribution percentages returned to the original ACA schedule, meaning lower-income households pay a smaller share of income and higher-income households (closer to 400% FPL) pay a larger share, with nothing available above that line.
Rough example for a family of four in Texas with a $70,000 household income (about 218% FPL):
- Expected contribution is a set percentage of income toward the benchmark Silver premium
- The tax credit covers the difference between that expected contribution and the actual benchmark Silver premium
- The same dollar credit applies whether the family picks Bronze, Silver, or Gold
A family of four earning above $128,600 in 2026 receives no premium tax credit at all and pays the full gross premium listed by the insurer, which is why comparing plans and shopping every year still matters even for higher earners.
The Texas Coverage Gap
Texas is one of the states that has not expanded Medicaid, and that creates a real gap for some residents. Adults without dependent children generally cannot qualify for Texas Medicaid at all, regardless of how low their income is. Parents with dependent children can qualify for Medicaid only if household income is extremely low, around 12% of the federal poverty level in many cases.
Because Marketplace subsidies only start at 100% FPL, adults earning below that amount who don't qualify for Medicaid fall into a coverage gap: too much income for Medicaid, too little income to get help paying for a Marketplace plan. More than 600,000 Texans are estimated to fall into this gap. If your income is uncertain or seasonal, it's worth checking both Medicaid and Marketplace eligibility, since Medicaid has no open enrollment window and you can apply at any time through YourTexasBenefits.com.
How to Apply for Texas Marketplace Coverage
- Gather your documents. You'll need Social Security numbers for everyone applying, estimated 2026 household income, and information on any employer coverage offered to you or your household.
- Go to healthcare.gov. Texas does not run its own exchange, so all applications and plan shopping happen on the federal site, not a state portal.
- Create an account and start an application. The system will ask about your household size, state, and income to determine subsidy eligibility before showing you plans.
- Compare plans across all metal tiers. Don't assume Silver is cheapest after the 2026 Texas Silver load; check Bronze and Gold prices side by side once your subsidy is calculated.
- Enroll by December 15, 2025 for January 1, 2026 coverage. Open enrollment for 2026 plans runs November 1, 2025 through January 15, 2026. Enrolling after December 15 pushes your coverage start date to February 1.
- Report income changes during the year. If your income changes, update your application on healthcare.gov so your subsidy amount adjusts and you avoid owing money back at tax time.
- Call for help if needed. The Marketplace call center number is 1-800-318-2596 for questions about applications, plan comparisons, or technical issues.
If you're unsure whether you'd do better with Medicaid, CHIP for your children, or a subsidized Marketplace plan, a free eligibility screening can compare all three against your specific household details before you commit to an application. Texans can also check general state benefits information on our /states/tx page for related programs like SNAP, CHIP, and LIHEAP.
Frequently Asked Questions
What is the income limit for ACA subsidies in Texas for 2026?
Subsidies are generally available to households earning between 100% and 400% of the federal poverty level. For 2026 coverage, that's $15,650 to $62,600 for a single person and $32,150 to $128,600 for a family of four, based on 2025 federal poverty guidelines.
Did Texas ACA subsidies get more expensive for 2026?
Yes, for most enrollees. The enhanced premium tax credits from 2021 through 2025 expired at the end of 2025, so subsidy amounts shrank and the income cap on eligibility returned at 400% FPL. The average net premium Texans pay increased from about $57/month in 2025 to about $89/month in 2026.
Can I still get a subsidy if I earn more than 400% of the federal poverty level?
No. For 2026, the subsidy cliff returned, meaning households above 400% FPL do not qualify for any premium tax credit and must pay the full gross premium.
Why did Texas add a 40% load to Silver plans in 2026?
Texas insurance regulators approved a rule requiring the extra cost to be added to Silver-tier pricing specifically. Because premium tax credits are calculated using the Silver benchmark plan, this increases subsidy amounts for everyone and can make Bronze or Gold plans cheaper than Silver after the credit is applied, even though Silver plans carry Cost-Sharing Reductions that Bronze and Gold do not.
What happens if I fall in the Texas coverage gap?
If your income is below 100% FPL and you don't qualify for Texas Medicaid because the state hasn't expanded it, you generally won't qualify for Marketplace subsidies either. Check whether you qualify for Medicaid based on other factors like disability, pregnancy, or having dependent children, since those categories have different, often lower income limits than the general adult population.
When is Texas open enrollment for 2026 Marketplace coverage?
Open enrollment runs November 1, 2025 through January 15, 2026. To have coverage start January 1, 2026, you need to enroll by December 15, 2025. Enrolling between December 16 and January 15 starts coverage February 1, 2026.
Does Texas have its own health insurance exchange?
No. Texas uses the federal Marketplace at healthcare.gov for all individual and family plan enrollment. There is no separate Texas state exchange or portal for ACA plans.
