Even without complete data, Texas is already seeing record enrollment for Affordable Care Act marketplace healthcare plans.
This is in spite of the expiration of enhanced subsidies, which many feared would raise premiums and cool access to healthcare.
Open enrollment started on Nov. 1 and ended Thursday. As of Jan. 3, more than 4.11 million Texans had signed up for marketplace plans, when there were still about two weeks left in the open enrollment period, according to the Centers for Medicare and Medicaid Services. Through a similar period last year, 3.86 million Texans had enrolled, for a 6.5% year-over-year increase, and 3.96 million enrolled in total for coverage in 2025.
Marketplace plans were subject to enhanced federal tax credits passed during the COVID-19 pandemic that expired at the end of 2025. Continuation of those subsidies was the primary sticking point last fall in what became the longest government shutdown in U.S. history, as Democrats insisted a funding bill include the subsidies, while Republicans wanted separate negotiations on healthcare.
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Experts warned that the expiration of subsidies could raise insurance premiums, with particular effects on Texans. Texas has the highest uninsured rate in the country, about double the national rate, and the state has opted not to expand Medicaid as allowed in the Affordable Care Act, meaning many Texans make too much for federal health insurance but too little to afford or have access to employer-provided healthcare.
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Marketplace plans help fill in that gap, with multiple levels of coverage — bronze, silver, gold, and platinum — some available at low to no cost. Since the implementation of subsidies, which have made those plans more accessible, Texas enrollment in marketplace plans has quadrupled.
Without the subsidies, according to a calculator from health policy non-profit KFF, a 33-year-old married couple with no kids in Dallas bringing home the city’s median household income of $67,760 could see their premiums rise about 50% for a silver plan, the most common level of coverage, and become ineligible for a no-cost bronze plan.
Texas’ enrollment increased without the subsidies. National enrollment through Jan. 3, compared to the similar period last year, dipped 3.5%. However, the data is still incomplete, and pure enrollments can’t tell the full story.
While Texas has record enrollment, we don’t yet know how many of those plans will actually go into effect once the first premium payment is made. The data doesn’t show how many Texans were automatically re-enrolled — and who might unenroll if their premiums rose intolerably. It’s also unknown which plans people enrolled in, meaning Texans may have needed to enroll in less coverage than before due to the higher premiums.
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