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Texas Health Insurance in 2027: Rules and Options

Texas buyers use HealthCare.gov, and the state has the second-largest Marketplace in the country with about 15 insurers filing for 2027. Texas requires insured group plans to offer state continuation, nine months for people without COBRA rights and six more months after COBRA ends, at the group rate plus 2 percent, though self-funded employer plans are exempt. Texas defines short-term plans by the federal rule rather than its own limit. Final 2027 individual increases average about 13 to 14 percent, with small-group plans up about 17 percent, which makes individual coverage reimbursement worth a look for small Texas employers.

Private health insurance in Texas

Most people I help in Texas end up on a private plan, not a Marketplace plan. Private, medically underwritten health insurance is priced on your age, zip code and health instead of your income, so a strong year never raises your premium and there is no tax credit to pay back in April.

Why people leave the Marketplace

Premiums keep climbing. Texas Marketplace premiums are rising 13.1% to 14.1% on average for 2027.
The subsidy cliff. Above 400 percent of the poverty level ($63,840 for one person, $132,000 for a family of four) you pay full price.
Surprise tax bills. Underestimate your income and you repay the tax credit in April.
Narrow networks. Many plans are local HMOs or EPOs that need referrals and cover little outside the area.
High out-of-pocket costs. 2027 out-of-pocket maximums reach $12,000 per person and $24,000 per family.
One window a year. Outside open enrollment you need a qualifying life event to enroll or switch.

What a private plan does differently

Start any month. If approved, coverage can begin the first of next month, with no wait for open enrollment.
Networks that travel. Many private plans use national PPO networks, which can give you in-network doctors outside Texas too. Networks vary by plan.
Can cost less than full-price Marketplace plans for some healthy applicants above the subsidy line.
Accident coverage the Marketplace does not offer. A private plan can be paired with accident coverage, a separate policy. What it includes varies by plan.
Approval is based on health. You answer health questions, and acceptance is not guaranteed.

With a significant health condition, or income low enough for a large tax credit, a Marketplace plan can be the better fit, and I will tell you if it is. Either way you see both side by side.

Private plans are not ACA Marketplace plans. Benefits, exclusions and pre-existing condition rules differ by plan and by state, so review the plan details before you enroll.

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Learn more: coverage not based on income · how underwriting works · private vs Obamacare · PPO plans for individuals · switching from the Marketplace

Where to enroll

Texas uses HealthCare.gov. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027. Private, medically underwritten plans are sold outside the exchange by licensed agents and can start the first of any month if you are approved.

Leaving a small employer

Texas requires insured group plans to offer state continuation for up to nine months to people not eligible for COBRA, or six more months after COBRA ends, at the group rate plus 2 percent. It does not apply to self-funded employer plans. Losing employer coverage also opens a 60-day Marketplace special enrollment period.

Short-term health plans

Texas defines short-term plans by reference to the federal rules, which set a three-month initial term and four months in total; federal agencies are not prioritizing enforcement of that limit while new rules are written. Short-term plans are medically underwritten, exclude pre-existing conditions and cap benefits, so they fit only a defined gap.

2027 premium changes

Texas individual-market premiums are set to rise 13.1% to 14.1% on average for 2027, with small-group plans up about 16.9%. The full breakdown is on the Texas 2027 rate page.

More Texas guides by job and situation

Texas questions

Where do Texas residents buy individual health insurance for 2027?

Texas uses HealthCare.gov. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027.

What happens to my group coverage if I leave a small employer in Texas?

How long can a short-term health plan last in Texas?

How much are Texas premiums rising for 2027?

Individual-market premiums are set to rise 13.1% to 14.1% on average, and small-group plans about 16.9%, based on final rate filings.

Sources: www.tdlr.texas.gov, tsbpe.texas.gov, statutes.capitol.texas.gov. Checked October 21, 2026. More on health insurance in Texas.

Licensed in Texas. I compare Marketplace and private plans side by side for your household, no fee.

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