Health coverage in Texas
Texas has not expanded Medicaid, and it holds a larger share of the people caught by that decision than any other state. If you are looking at coverage here, this is the part worth understanding first.
Has Texas expanded Medicaid?
No. Texas has not expanded Medicaid.
Help with a Marketplace premium starts at 100% of the federal poverty level, and Texas Medicaid covers a narrower group of adults than that.
How big is the coverage gap in Texas?
Larger than anywhere else. Roughly 1.4 million people nationally are in the coverage gap, and about 42% of them live in Texas.
Below 100% of the poverty level a Texas adult can be caught between the two systems: too much income for Texas Medicaid, too little for help with a Marketplace premium. That is a consequence of a state policy decision, not of anything the person did.
Applying for Texas Medicaid is still worth doing. The rules reach more people than most expect, especially households with children, someone who is pregnant, or someone with a disability. Community health centres and hospital charity care exist as well.
Who gets the most help in Texas?
Between 100% and 138% of the poverty level. Households in that band get the largest help with the premium the Marketplace offers, plus cost-sharing reductions that lower what you pay when you use the plan.
The band is wide in Texas for the same reason the gap is: the state did not widen Medicaid to 138%, so those households stay on the Marketplace.
How many people used the Marketplace in Texas?
CMS counted 1,265,670 new Marketplace consumers in Texas for 2026 — the second largest number in the country.
Can this page tell me whether I am in the gap?
No. Household size moves the line, and your exact income decides it. This page cannot work that out and should not pretend to.
Apply for Texas Medicaid, and talk to a licensed agent about a Marketplace plan. Doing both is normal, and neither one commits you to anything.
Which parts of Texas do you cover?
All 254 counties. Wherever you are in Texas, your details go to an agent who holds a licence in Texas — that is the only agent this system will route you to.
The county count comes from the US Census Bureau's ZIP-code-to-county relationship file, 2020 geographies.
The other states we work in
The rules are not the same in each one, so each state has its own page.
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