Affordable options for Texans in the ACA open enrollment period

With the ACA Marketplace open enrollment now underway, Texas 2036 has been taking a closer look at what new premiums mean for Texans seeking coverage. Texas 2036’s “Who are the Uninsured” report revealed that, as of 2022, nearly 40% of the uninsured population were eligible for a completely free plan but remained unenrolled.

While we are not yet able to assess what percentage of uninsured individuals are eligible for free plans this year, we do now have access to premiums for the ongoing open enrollment period. This presents an opportunity for many uninsured Texans to gain access to affordable health insurance, as recent premium data demonstrates.

We’ve calculated the net premiums for a single adult at 250% of the Federal Poverty Level, and the results underscore the affordability now available across various metal levels in Texas’ largest counties. These net premiums reflect monthly payments after applying the available subsidies based on income, making health insurance an accessible and manageable option for millions of Texans.

Affordable Net Premiums for a Single Adult at 250% FPL ($37,650)

Below is a table showing net premiums in Bronze, Silver and Gold plans for individuals in the 10 largest counties in Texas. These numbers reveal the range of choices Texans have, allowing individuals to select plans that balance monthly premium costs with coverage levels tailored to their health care needs.

 

If you’re wondering why “silver” premiums are higher than “gold” premiums, it is because silver plans include additional benefits for certain lower-income enrollees that make these plans more generous for those enrollees than gold plans.

Initially, these extra benefits were funded separately by the federal government, but since 2017, these benefits have been funded by silver-level premiums, a practice known as “silver-loading.” A Texas law passed in 2021 optimized how these premiums should be calculated, which had the direct impact of improving affordability for bronze and gold plans.

What Does This Mean for Texans?

For this upcoming open enrollment period, these example premiums show that health insurance coverage remains incredibly affordable for millions of Texans.