ACA Open Enrollment 2026 Texas: Deadlines, Subsidies & What Changed
ACA Open Enrollment 2026 Texas: Deadlines, Subsidies & What Changed
If you have an ACA Marketplace health plan in Texas, 2026 brought significant changes that affect how much you pay for coverage. The enhanced subsidies that were available from 2021 through 2025 under the American Rescue Plan and Inflation Reduction Act have expired, and the 400% Federal Poverty Level (FPL) income cap has returned. Here's what residents of Corpus Christi, Laredo, McAllen, Harlingen, Brownsville, Victoria, San Antonio, and all of South Texas need to know.
What Changed in 2026?
Enhanced Subsidies Expired: From 2021–2025, enhanced subsidies made ACA plans more affordable for middle-income Texans — including those earning above 400% FPL. As of January 1, 2026, those enhanced subsidies are gone.
The 400% FPL Cliff Is Back: If your household income is above 400% of the Federal Poverty Level, you no longer qualify for a premium tax credit. For 2026, that threshold is approximately:
- Single person: $63,840/year
- Family of 2: $86,560/year
- Family of 4: $131,960/year
What Stayed the Same: Cost-sharing reductions (CSRs) for Silver plans, Medicaid eligibility rules, and the 10 Essential Health Benefits requirement all remain in place.
2026 ACA Open Enrollment Dates
- Open Enrollment: November 1, 2025 – January 15, 2026
- Coverage Start Date (if enrolled by Dec 15): January 1, 2026
- Coverage Start Date (if enrolled Dec 16 – Jan 15): February 1, 2026
If you missed open enrollment, you may qualify for a Special Enrollment Period due to:
- Loss of other health coverage
- Marriage, divorce, or domestic partnership change
- Birth, adoption, or placement of a child
- Moving to a new coverage area
- Income change affecting subsidy eligibility
2026 Federal Poverty Level Income Limits (48 Contiguous States)
| Household Size | 100% FPL | 138% FPL (Medicaid) | 400% FPL (Subsidy Cliff) |
|---|---|---|---|
| 1 person | $15,960 | $22,025 | $63,840 |
| 2 people | $21,640 | $29,863 | $86,560 |
| 3 people | $27,320 | $37,702 | $109,280 |
| 4 people | $33,000 | $45,540 | $132,000 |
Source: HHS 2026 Federal Poverty Level Guidelines
The Texas Coverage Gap
Texas has not expanded Medicaid under the ACA. If your income is below 100% FPL, you may fall in the "coverage gap" — too high for traditional Medicaid, but too low for marketplace subsidies. Approximately 1.5 million Texans are estimated to be in this gap.
If you're in this situation in Corpus Christi, Laredo, McAllen, or South Texas, Jay Gutierrez can help you explore all available options including CHIP (for children), community health centers, and other programs.
Cost-Sharing Reductions (CSR) — Still Available in 2026
If your income is between 100% and 250% FPL, you may qualify for Cost-Sharing Reductions on Silver plans. CSRs lower your deductible, copays, and out-of-pocket maximum — sometimes dramatically:
- 100–150% FPL: Deductibles as low as $0–$500, out-of-pocket max as low as $1,000
- 150–200% FPL: Deductibles around $500–$1,500
- 200–250% FPL: Deductibles around $1,500–$3,000
CSRs are only available on Silver plans. If you qualify, a Silver plan is almost always the best value.
Use Our Free 2026 ACA Subsidy Calculator
Not sure if you qualify for a subsidy? Use our free 2026 ACA Subsidy Calculator to estimate your premium tax credit based on official IRS and HHS data. Enter your household income, size, and age to see your estimated monthly savings in seconds.
Get Help in South Texas
Jay Gutierrez at Texas Health Insurance Group helps individuals and families throughout Corpus Christi, Laredo, McAllen, Harlingen, Brownsville, Victoria, Alice, Kingsville, Rockport, Portland, Aransas Pass, Beeville, Sinton, San Antonio, and all of South Texas navigate ACA open enrollment.
Call (361) 267-5977 or schedule a free consultation to review your 2026 options.
Sources: HHS 2026 Federal Poverty Level Guidelines; IRS Rev. Proc. 2025-25; CMS.gov; Healthcare.gov.
Jay Gutierrez is a licensed insurance agent at Texas Health Insurance Group in Corpus Christi, TX. He helps South Texas families and businesses find the right health, dental, vision, life, and Medicare coverage.
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