Your monthly health insurance premium could triple by January. Not a typo—$2,000 to $3,000 per month for a family of four, up from potentially zero or a few hundred dollars today. Nearly 4 million Texans enrolled in Affordable Care Act marketplace plans now face this financial cliff if Congress doesn’t act by December 31.
The enhanced premium subsidies that made ACA coverage affordable since 2021 expire at year-end. Health insurance brokers in Texas are sounding the alarm—without these subsidies, regular families simply can’t afford marketplace coverage. Open enrollment for 2026 started November 1, but the subsidy question remains unanswered in Washington.
Should you enroll now or wait? What happens if you’re mid-application when subsidies disappear? Here’s what Texas families need to know before the December enrollment deadline.
Why Texas Health Insurance Premiums Could Hit $3,000/Month
The math is brutal without subsidies. Kyle, a health insurance broker at Texas Enrollment Office, puts it bluntly: “If it doesn’t extend to 2026, you’re looking at a family of four probably paying $2,000 or $3,000 a month for premium.”
That’s the actual cost of comprehensive health coverage in Texas. Right now, enhanced subsidies cover most or all of that expense for millions of families. Take them away, and you’re left with the real price tag—one that puts coverage out of reach for working-class households.
Three factors explain the sticker shock:
- Healthcare costs in Texas run high. Hospital networks, specialty care, prescription drugs—insurance companies pay these bills and pass costs to policyholders through premiums.
- Texas didn’t expand Medicaid, pushing more lower-income residents into the ACA marketplace where premiums reflect higher medical utilization rates.
- Without subsidies, healthier people drop coverage. Only sicker, higher-cost individuals remain insured, driving premiums even higher in a vicious cycle.
The Kaiser Family Foundation estimates individuals currently paying around $705 annually with enhanced subsidies would face the full unsubsidized rate—often $8,000 to $12,000 per year for a single person, $20,000+ for families.
4 Million Texans at Risk: Who Gets Hit Hardest
Nearly 4 million people enrolled in ACA marketplace plans in Texas during 2025. That’s more than the entire population of Connecticut. In Bexar County alone, over 235,000 residents depend on marketplace coverage, according to Century Foundation data.
Who are these 4 million Texans?
| Income Level | Current Subsidy Impact | Risk Without Subsidies |
|---|---|---|
| Below 200% poverty level | Pay $0–$50/month with subsidies | Face $500–$1,500/month—complete loss of coverage likely |
| 200-400% poverty level | Pay $100–$400/month | Premiums jump to $800–$2,000/month—many will drop coverage |
| Above 400% poverty level | Enhanced subsidies eliminated income cap in 2021 | Middle-class families suddenly paying full freight |
Kyle sees these families daily in his San Antonio office. “Many low income families rely on those subsidies to be able to afford their health insurance, be able to pay the insurance,” he explains. “A lot of people, they’ll be paying zero co-pays for doctor visits, $10 special visits, getting their medications for free.”
Without subsidies, those same families face impossible choices. Skip healthcare. Go into debt. Drop coverage and hope nothing bad happens.
What Happens During 2026 Open Enrollment Right Now
Open enrollment started November 1, 2025 and runs through January 15, 2026. But here’s the problem: nobody knows if subsidies will exist when coverage starts January 1.
Congress could vote to extend subsidies by the second week of December—but that’s not guaranteed. Republicans and Democrats remain at odds over ACA funding, even after the recent government shutdown ended without resolution.
So what should Texas families do right now?
Enroll anyway. Health insurance experts across Texas agree: don’t wait for Washington to decide your healthcare fate. Here’s why:
- You can change or cancel plans later if subsidy status changes before coverage starts.
- Missing the enrollment window is worse than enrolling with uncertainty—you can’t get coverage later without a qualifying life event.
- If subsidies extend, you’re already enrolled at the lower rate. If they don’t, you can reassess before January 1.
- The December 15 deadline matters most for coverage starting January 1. That gives Congress a few weeks to act before you’re locked in.
The Healthcare.gov marketplace will show estimated premiums based on current subsidy rules. Just understand those numbers could change if Congress doesn’t extend enhanced subsidies.
Can Congress Still Save ACA Subsidies for 2026?
Technically, yes. Practically, it’s complicated.
Senate Democrats pushed hard to include subsidy extension in the recent government funding negotiations. That effort failed when the shutdown ended without an ACA provision. Now both parties face a December deadline to act separately on healthcare subsidies.
Three scenarios are possible:
- Full extension through 2026 or beyond: Enhanced subsidies continue as-is, preserving affordability for millions. Requires bipartisan support or Democratic leverage in budget negotiations.
- Partial extension or modified subsidies: Republicans might propose alternative subsidy structures, potentially with tighter income limits or different subsidy formulas. Better than nothing, but could still raise costs for many Texans.
- No action—subsidies expire December 31: The doomsday scenario where 4 million Texans face massive premium increases starting January 1, 2026.
The political reality? Republicans control Congress and generally oppose expanding or extending ACA subsidies. But they also don’t want 4 million angry Texas voters—plus millions more nationwide—losing health coverage or facing unaffordable premiums in an election year.
That political pressure could force compromise, but time is running short.
Your Health Insurance Options If Subsidies Disappear
Let’s say December 31 arrives and subsidies expire. Your ACA marketplace premium quote triples overnight. What options exist beyond just paying the higher rate or going uninsured?
Employer-sponsored insurance: If you or your spouse can access workplace coverage, this becomes your best option even if you previously chose marketplace plans. Employer plans don’t depend on ACA subsidies.
Medicaid (limited in Texas): Texas hasn’t expanded Medicaid, so eligibility remains extremely limited—primarily pregnant women, children, disabled individuals, and very low-income parents. Most working adults don’t qualify regardless of income.
Short-term health plans: These plans cost less than ACA coverage but offer minimal protection. They exclude pre-existing conditions, cap benefits, and leave you exposed to major medical expenses. Not a real solution for families needing comprehensive coverage.
Health sharing ministries: Faith-based cost-sharing arrangements aren’t insurance and provide no guaranteed coverage. Members share medical expenses voluntarily—risky for anyone with ongoing health needs.
Go without coverage: The individual mandate penalty no longer exists at the federal level (though some states still impose penalties). But going uninsured means paying full price for all healthcare—a single hospital stay can bankrupt a family.
Kyle’s assessment is stark: “It’s just very expensive, very expensive, and a regular person just can’t afford it.”
None of these alternatives match the comprehensive, guaranteed coverage ACA marketplace plans provide with subsidies. That’s why the subsidy expiration matters so much.
Enrollment Deadlines You Can’t Afford to Miss
Mark these dates on your calendar right now:
| Date | What Happens | Action Required |
|---|---|---|
| November 1, 2025 | Open enrollment begins | Start shopping for 2026 plans |
| December 15, 2025 | Deadline for January 1 coverage | Must enroll by this date for seamless coverage |
| December 31, 2025 | Enhanced ACA subsidies expire | Congress must act by this date to extend subsidies |
| January 15, 2026 | Open enrollment ends | Final deadline—no coverage available after this without qualifying event |
The sweet spot? Enroll between December 1-15. That gives you time to see if Congress extends subsidies (likely voted on by mid-December) while still meeting the January 1 coverage deadline.
If Congress doesn’t act by December 15, you can still change or cancel your enrollment before January 1 if the premium without subsidies is unaffordable.
Frequently Asked Questions
What happens to my 2025 ACA coverage if subsidies expire?
Your 2025 coverage continues unchanged through December 31, 2025. Enhanced subsidies remain in effect for all of 2025. The expiration only affects 2026 coverage starting January 1. If you’re currently enrolled with subsidies, nothing changes until your plan renews for the new year.
Should I enroll during open enrollment even though subsidies might disappear?
Yes. Texas insurance brokers strongly recommend enrolling during the November 1 to January 15 open enrollment period regardless of subsidy uncertainty. You can change or cancel your plan later if subsidy status changes before coverage starts January 1. Missing the enrollment window leaves you without coverage options until the next open enrollment or a qualifying life event.
How much would a Texas family pay for health insurance without ACA subsidies?
A family of four in Texas would pay approximately $2,000 to $3,000 per month ($24,000–$36,000 annually) for comprehensive ACA marketplace coverage without enhanced subsidies, according to Texas insurance brokers. Individual coverage typically costs $700–$1,000 monthly ($8,400–$12,000 annually) without subsidies. These rates reflect actual premium costs that subsidies currently cover.
Can Congress still extend ACA subsidies before they expire December 31?
Congress can extend subsidies anytime before December 31, 2025. A vote is expected by the second week of December during budget negotiations. However, extension requires bipartisan support or Democratic leverage in funding bills. If Republicans don’t agree on alternatives, they must decide whether to join Democrats in extending subsidies or allow them to expire, affecting millions of voters nationwide.
What alternatives exist if ACA subsidies disappear and marketplace coverage becomes unaffordable?
Limited options exist for Texas families facing unaffordable premiums. Employer-sponsored insurance becomes the best alternative if available through your or your spouse’s workplace. Texas hasn’t expanded Medicaid, so most working adults don’t qualify. Short-term health plans cost less but exclude pre-existing conditions and cap benefits. Health sharing ministries aren’t insurance and provide no guaranteed coverage. Going uninsured risks financial catastrophe from unexpected medical expenses.
Bottom Line: Don’t Wait for Washington
Nearly 4 million Texans can’t afford to gamble on congressional action. The December 15 deadline for January 1 coverage arrives whether or not subsidies get extended.
Your move? Enroll during open enrollment. Get the best plan you can find based on current subsidy estimates. Watch the news for congressional action through mid-December. If subsidies disappear and premiums triple, reassess your options before January 1.
But don’t let Washington’s dysfunction leave you without health coverage. The cost of going uninsured—one serious illness or accident—dwarfs even the inflated premiums Texas families might face without subsidies.
Visit Healthcare.gov or contact a licensed Texas insurance broker to explore your 2026 options. The enrollment clock is ticking, regardless of what happens in Congress.