13.1%: The Proposed Hike in Texas Health Insurance Costs

Health insurers in Texas are proposing a 13.1% increase in monthly premiums for Affordable Care Act plans in 2027. This potential rate hike follows a finalized 20% increase for 2026 coverage. The proposed changes affect nearly 3.3 million Texans enrolled in marketplace plans as of February.

Open enrollment for the 2027 plan year opens next week and runs through January 15. If finalized, the 13.1% median increase would mark the second consecutive year of double-digit price jumps. Nationwide, insurers are proposing a median increase of about 15%, according to the Peterson Center on Healthcare and KFF.

Researchers at Georgetown University cite the expiration of enhanced premium tax credits as a primary driver of the cost surge. Congress introduced those credits in 2021 to close coverage gaps during the pandemic. They lapsed in 2025 after a prolonged government shutdown, a period when Democrats refused to reopen the government unless Republicans preserved the subsidies.

The loss of those credits coincided with inflation, medical labor shortages, and rising pharmaceutical costs. These factors combined to push up monthly premiums. Nationally, approximately 3 million fewer people held ACA insurance in February 2026 than in February 2025. Health experts attribute this drop to the loss of the enhanced credits.

Ashleigh Alvarez, senior program manager for Foundation Communities’ Prosper Health Coverage program, noted that rising costs for insured individuals often stem from the growing number of uninsured people. Her organization has helped over 65,000 Texans find affordable insurance since 2014. Alvarez said the current structure places financial pressure on those who remain insured.

"It all falls on people who have insurance, which isn't fair," Alvarez said. "However, if people were able to be eligible for these premium tax credits to help them pay for insurance .. then that would remove the additional risk of more uninsured people."

Eligibility for remaining subsidies requires household income between 100% and 400% of the federal poverty line. For an individual, that range is $15,960 to $63,840 annually. Starting next year, federal policy limits premium tax credits to U.S. citizens, green card holders, and specific immigrants from Haiti, Cuba, and three small North Pacific nations. Refugees, asylum seekers, and visa holders will no longer qualify for these government subsidies.