Texas ACA Enrollment Drops for the First Time Since 2019 — What It Means for You

Texas ACA Enrollment Drops for the First Time Since 2019 — What It Means for You

New federal data shows Texas’ Affordable Care Act enrollment fell about 4% this year, dropping from roughly 3.42 million effectuated enrollees in 2025 to 3.28 million in 2026 — the first year-over-year decline the state has seen in years. The drop follows the expiration of enhanced federal subsidies that had kept many marketplace premiums low or free.

Even so, Texas actually outperformed most of the country, with a national effectuation decline of 12% compared to Texas’ smaller 4% drop. Experts point to a state pricing policy that has kept bronze and gold plan premiums relatively low as one reason Texans didn’t see the same falloff other states did.

One of the more telling numbers: nearly 900,000 of the 4.17 million Texans who selected an ACA plan during open enrollment never ended up paying for it or later canceled — often because people who’d been auto-enrolled in a previously free plan didn’t realize their premium was no longer $0 once subsidies lapsed.

The plan mix shifted too — gold and bronze plans overtook silver as the most popular choices in 2026 for the first time, as buyers adjusted to higher costs.

Why this matters for our clients: if you or someone you know had a marketplace plan on autopilot, it’s worth double-checking that premium is actually being paid — and that the coverage still makes sense at the new price. This is exactly the kind of thing that’s easy to miss until a claim gets denied.

Not sure where you stand with your coverage? Give us a call — we’re happy to take a look and make sure you’re not caught off guard.