The premiums for the Affordable Care Act are poised to rise by an average of 35.2% in Texas when open enrollment starts on November 1. This increase follows the insurance sector’s reaction to escalating costs and the looming expiration of the premium tax credit.
This rise will be particularly noticeable in Texas, ranking it among the states with the highest percentage hikes. The average monthly premium for a 40-year-old individual was $489 in 2025 before tax credits. According to a health policy organization, insurers in Texas plan to charge around $661 for benchmark plans in 2026, marking the steepest percentage increase since 2018.
The same organization noted that states using Healthcare.gov, like Texas, experience faster premium increases than those with their own state-based exchanges.
Ending the enhanced premium tax credit will cause individuals’ premium costs to climb significantly more than the basic rate increases. In 2021, Congressional Democrats had broadened the eligibility for this tax credit, which helps offset premiums based on income; however, these enhancements are set to lapse at the end of 2025, leading many enrollees to shoulder higher costs.
Currently, those with incomes between 100% and 150% of the federal poverty level can access free plans. But once the credits expire, individuals will need to pay between 2.1% and 4.19% of their premiums based on their income levels. Essentially, as incomes rise, so too do the amounts individuals are expected to cover.
Nationwide, estimates indicate that average payments for ACA customers may more than double—up by 114% factoring in tax credits. Insurers attributed their increases to the anticipated termination of these credits, despite public bidding starting soon. Congress remains gridlocked, with Democrats withholding support for a Republican bill to fund the government, which has now led to a shutdown lasting 31 days.
ACA enrollees will still have the option to choose from various metal-tier plans with differing coverage and premium levels.
KFF reports that premiums across all metal tiers in Texas are on the rise. Premiums for the lowest-cost Bronze plan could increase by 19.7%, while the Silver and Gold plans may see jumps of 35.1% and 31.9%, respectively.
Multiple factors influence individual premium costs, including the insurance provider, plan type, age, and geographic region, as well as expected income determining tax credit sizes.
Texas is likely to bear the brunt of tax credit expirations, holding nearly 4 million ACA enrollees, second only to Florida. The ACA has significantly expanded coverage for low-income Texans, particularly because Texas hasn’t extended Medicaid to those earning over 100% of the federal poverty level. Nearly two-thirds of those insured through the ACA fall below 150% of this threshold.
Yet, the potential loss of enhanced tax credits could compel low-income Texans, who are accustomed to free or low-cost coverage, to either switch plans or discontinue coverage altogether upon seeing increased premium rates in 2026. The restoring of the eligibility limits means over 126,000 Texans could face steep premium increases.
Depending on the health insurance organization, it’s estimated that hundreds of thousands—perhaps over a million—Texans could lose their health insurance due to these premium hikes. KFF offers a calculator to help ACA members gauge their potential premium increases, and Texans can view available plans on a specified website.
