Health insurance in Texas
Texas uses HealthCare.gov and has not expanded Medicaid, which leaves the largest coverage gap in the country. If you're in it and in good health, an underwritten private plan is frequently the only affordable route — and it's the one nobody mentions.
What I look at first in Texas
- Where your income lands decides everything. Above the Medicaid line but under the subsidy line is the hard place, and it is the one a medically underwritten private plan is built for.
- Your income estimate for next year, not last year. Your subsidy is built on what you expect to earn, and a stale figure is the most expensive mistake on this page.
- The doctors and prescriptions you are not willing to lose. Networks change every plan year, so I check yours before you enroll, not after.
Outside Open Enrollment you need a qualifying life event to start a Marketplace plan — losing other coverage, moving, marriage, a birth, turning 26. Medicaid and CHIP have no window at all, so those you can apply for any day of the year.
Where these facts come from
Marketplace type is published by CMS for plan year 2027. Medicaid expansion status is tracked by healthinsurance.org. Open Enrollment dates are HealthCare.gov’s. Which carriers and which plan types I can place in Texas depends on my appointments there, so I tell you that on the call rather than guessing at it here.