As of 2019, over 5.2 million people in Texas didn’t have health insurance. That’s according to a report from the Kaiser Family Foundation (KFF), a nonprofit that focuses on healthcare, and it represents 18.4% of the state’s population — nearly twice the national average.
When KFF analyzed the uninsured rate again in 2021, they found that of the people without health insurance in Texas, just over 2.8 million of them could qualify for marketplace coverage.
Marketplace health insurance is regulated by the country’s current healthcare law, the Affordable Care Act (ACA). The ACA established requirements for major medical plans sold today. Among them are that these plans have to cover 10 essential health benefits and can’t deny people with pre-existing conditions.
The law also lays out advance premium tax credits, aka subsidies, to help more people afford health insurance. Under the ACA, people with incomes of 100% to 400% of the federal poverty level qualify for subsidies to lower monthly premium costs.
These subsidies can even reduce premiums down to zero. In fact, KFF estimates that of the marketplace-eligible people in Texas without health insurance in 2021, about 37% of them could use a subsidy to get a bronze plan for free.
The nonprofit also analyzed premiums in Texas for 2021. They found that average lowest cost options by metal tier were $301 a month for bronze plans, $420 for silver plans and $429 for gold. These averages are for the lowest prices in these categories. They also don’t include premium subsidies.
Using our own marketplace, we found that a 40-year-old living in Arlington, TX, making $37,000 a year could find a bronze plan for a little over $147 a month.
What you pay for coverage depends on where you live in the state, as does plan availability. There are 10 insurers offering marketplace coverage in Texas in 2021. Among them are Oscar, Molina, Scott and White, Centene, and Friday Health Plans.
Sources
Kaiser Family Foundation, “Health Insurance Coverage of the Total Population”
Kaiser Family Foundation, “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach” (January 27, 2021)
Kaiser Family Foundation, “Average Marketplace Premiums by Metal Tier, 2018-2021”
Kaiser Family Foundation, “Insurer Participation on the ACA Marketplaces, 2014-2021” (November 23, 2020)