Texans who enroll in an insurance plan on the Affordable Care Act marketplace may be faced with higher premiums this year — and health insurance navigators are urging them to reach out for support. Open enrollment for coverage in 2026 begins Nov. 1.
Foundation Communities' Prosper Health Coverage Team helps thousands of Texans who do not receive health insurance through their employer enroll in a marketplace plan through healthcare.gov each year.
"Premiums are going up, but really depends on your specific individual circumstance — what's your income, what's your household, which plan are you shopping for?" said Walter Moreau, executive director of Foundation Communities. "We hope people will not be afraid and will come in and get coverage."
In Texas and other states that use healthcare.gov, marketplace health plan premiums have increased by an average of 30% year-over-year, per an analysis by the health policy organization KFF.
Most Americans who purchase insurance via the marketplace do not pay the full price set by insurers. Rather, they qualify for tax credits relative to their household size and income that offset their costs.
In 2021, the Biden administration instituted an additional "premium" tax credit. It gave another layer of assistance to the poorest marketplace customers and subsidized earners who make four times the federal poverty level for the first time. Since 2021, the number of Texans enrolled in marketplace plans has more than tripled. Nearly 4 million Texans are currently enrolled in a marketplace plan, including nearly 145,000 in Travis County.
But the premium tax credit will expire at the end of the year unless Congress acts to extend it — a key point of contention in the ongoing federal government shutdown, with Democrats pushing for an extension.
KFF estimates that marketplace customers will see their premium costs go up by 114% on average if the ACA premium tax credit expires. A study from Texas A&M University's Bush School of Government and Public Service predicts that hundreds of thousands of Texans may forgo health insurance due to increased costs this year, exacerbating Texas' already high uninsured rate.
"These are the people we're trying to appeal to in Central Texas to say, 'don't lose your coverage. Come and find out what the possibilities are,'" said Congressman Lloyd Doggett, an Austin Democrat, at a news conference hosted by Foundation Communities.
With the fate of the premium tax credit uncertain, Moreau acknowledged that this enrollment season could be especially confusing for customers — but he urged them to go ahead and get enrolled and make changes later in the enrollment season if needed.
"Our counselors are trained and here to hold your hand and kind of walk you through the process," he said. "If the premiums are enhanced, I don't know what that's going to mean yet, but we encourage people to get the knowledge about the plans that are available right now, and then we'll be here if something changes."
Open enrollment lasts through Jan. 15, but customers need to sign up by Dec. 15 to ensure coverage will begin at the start of 2026.
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