Texas Health Insurance Built Around Your Life

Ryan Michalek, Licensed Health & Life Insurance Agent, NPN 21043091. Last updated November 8, 2026 · Read my Google reviews

How health coverage works in Texas

Texas uses the federal HealthCare.gov marketplace for ACA plans, which are guaranteed-issue and subsidy-eligible if you qualify. But a lot of self-employed Texans earn too much for subsidies and need another route. Private under-65 plans often provide PPO-style flexibility and can be enrolled any time of year. I compare both and tell you straight which fits. If you work for yourself, the Texas self-employed & 1099 health insurance guide walks through your options in depth. If you're weighing buying your own plan more broadly, see Texas individual health insurance. For 2027, the marketplace in Dallas and Houston offers no PPO plans at any metal level, only HMO, EPO and POS plans (public marketplace quotes checked October 31, 2026). Can you still get a PPO in 2027?

What the 2027 plan data shows in Texas. Two Texas facts change how I’d shop. First, in all 254 counties the lowest-priced gold plan for a 60-year-old costs less than the benchmark silver, by at least $140 a month and about $210 in a typical county, so Houston isn’t the exception. Second, 20 counties around Abilene and Wichita Falls have one insurer, with benchmarks of about $2,076 to $2,200. Either way, I’d price gold first.

Sources: CMS marketplace plan data for 2027 (QHP Landscape, individual medical, data.healthcare.gov, updated October 30, 2026); age 60, no subsidy; checked November 12, 2026. See every county’s 2027 numbers.

If you lose job-based coverage in Texas. Texas law adds its own continuation on insured group plans: 9 months if federal COBRA doesn't apply to you, or 6 more months after COBRA ends if it does, once you've been covered 3 months (Tex. Ins. Code 1251.255). Texas hasn't expanded Medicaid, and adults without children generally can't qualify on income alone.

Sources: Tex. Ins. Code 1251.251-1251.255; KFF; checked November 12, 2026.

More Texas rules that change the answer. Texas has its own family rule: if you lose group coverage because the family relationship ends, such as a divorce, and you'd been on the plan at least a year, Texas law lets you keep it for up to 3 years (Tex. Ins. Code 1251.301 to 1251.310). It runs separately from COBRA, not on top of it.

Sources: Tex. Ins. Code 1251.301-1251.310; checked November 12, 2026.

Houston, Dallas, Austin, and the Texas 1099 economy

Texas has one of the highest uninsured rates in the country, and a big reason is how many Texans work for themselves. Around Houston it’s the energy economy: consultants, landmen and oilfield service contractors whose income moves with the rig count. In Dallas–Fort Worth it’s a sprawling base of trades, logistics, and small-business owners; in Austin it’s the tech freelancers, startup contractors, and creative class; and in San Antonio and the Rio Grande Valley it’s service businesses and family firms. For all of them, the real puzzle is pairing a 1099 income with a plan whose network holds up across a huge state, and that’s the work I do. See Dallas & DFW coverage

Texas, region by region: from the Metroplex to the Valley

Texas is too big for one answer. The same 60-year-old sees a different price, a different number of insurers and a different network depending on which part of the state they call home. Here's how it breaks down by the regions Texans actually name, using 2027 marketplace prices I checked November 1, 2026 and the Census Bureau's 2025 American Community Survey.

• Dallas-Fort Worth and Tarrant County. The Metroplex has the biggest group in Texas of working-age adults who buy their own coverage while earning more than four times the poverty level: about 169,000 people. The 2027 benchmark silver plan for a 60-year-old in Dallas is about $1,588 a month, up about 11%. If you're looking for self-employed health insurance in Fort Worth, or an independent health insurance agent who covers Arlington, Grand Prairie and Plano too, the Dallas and DFW health insurance guide goes deeper on the metro.
• Greater Houston, Katy, Fulshear and The Woodlands. Houston has eight marketplace insurers for 2027, against three in Lubbock and two around Lufkin, and it's one of the places where the lowest-cost gold plan came in about $151 a month under benchmark silver for a 60-year-old. It's also home to the Texas Medical Center, which describes itself as the largest medical complex in the world, so for a lot of families out in Katy or up in The Woodlands the real question is whether a plan's network reaches the specialists they already see there.
• Austin and the Hill Country. Austin skews young and high-earning: about 33% of households make $150,000 or more, and only about 28.5% of adults 26 to 64 are 50 or older, against about 33% statewide. That points to young families living on startup and tech income more than early retirees, which is why a family plan on self-employed income is usually the first thing I walk through with someone looking for a health insurance broker in Austin, TX.
• San Antonio and the I-35 corridor. The Texas Workforce Commission's 2026 WARN notices list several San Antonio layoffs this fall, including 230 workers at one logistics company in September and 153 at another employer in early November. If your job plan ends with one of those notices, compare your options after losing employer coverage before you default to COBRA.
• The Permian Basin (Midland and Odessa). Midland went from four marketplace insurers to three for 2027, and none of them offers a PPO. Oilfield income swings with prices, so a strong year can lift a household over the subsidy line after the fact; how that credit settles on your return is a question for your CPA, and premium tax credit repayment explains what to ask.
• West Texas and the Panhandle (Lubbock and Amarillo). Lubbock is where the gap shows most: about $1,957 a month for the 60-year-old benchmark, roughly 38% above Houston, with the insurer count down from five to three. Farm and ranch families out here also see Texas Farm Bureau's member health plan, which is a different product from insurance under Texas law; I lay out the differences in Farm Bureau health plans compared and health insurance for farmers and ranchers.
• East Texas and the Piney Woods (Tyler, Longview, Lufkin). Around Lufkin only two marketplace insurers remain, and the benchmark runs about $1,809 a month. Tyler is a surprise: about 4.2% of its adults 19 to 64 buy their own plan with income above four times the poverty level, one of the highest shares among Texas metros in the Census figures and ahead of Houston and Austin.
• The Rio Grande Valley (McAllen, Edinburg, Mission and Brownsville). The McAllen metro has the highest self-employment rate of the larger Texas metros, about 14.7% of workers, and a median household income near $55,900. Many households there land inside the subsidy range, so a marketplace plan with a tax credit is often the right first look, and I'll tell you that plainly.

Sources: MHS 2027 marketplace price checks (November 1, 2026; benchmark silver, one 60-year-old, no subsidy; see what private health insurance costs by state). U.S. Census Bureau, 2025 American Community Survey 1-year estimates by metro area: table B27016 (direct-purchase coverage by income-to-poverty ratio), B24080 (class of worker), B19001 (household income), B19013 (median household income), B01001 (age). Texas Workforce Commission, WARN Act listings 2026 (checked November 7, 2026). Texas Medical Center, About TMC. Smaller metros carry wider margins of error.

Texas work that shapes the coverage question

• Pipeline welders, oilfield service hands and landmen paid on a 1099 between Houston and the Permian: health insurance for contractors and the skilled trades.
• Travel and contract nurses rotating through the Texas Medical Center and the big DFW hospital systems: coverage for travel and 1099 nurses.
• Austin software contractors and IT consultants who left a W-2 job for client work: health insurance for IT consultants.
• Realtors working the Houston, North Texas and Austin markets on commission: health insurance for real estate agents.
• Pastors and staff at smaller Texas congregations with no church group plan: health insurance for pastors.

Living near the Oklahoma, Arkansas or Louisiana line

Texarkana straddles the Arkansas line, Orange and Beaumont sit a short drive from Lake Charles, and plenty of people in Sherman and Denison cross the Red River into Oklahoma for work. An individual plan generally follows the state where your home is, not where the paycheck comes from, so a family on the Arkansas side of Texarkana shops Arkansas plans. Before you pick one, check that its network includes the doctors and hospitals you use on both sides of the line, because networks are drawn county by county. I'm licensed in all three neighbors too: Arkansas, Oklahoma and Louisiana.

2027 in Texas: what changed

• Fewer choices outside the big cities. Houston has eight marketplace insurers for 2027, one more than in 2026. In Lubbock the count fell from five to three, in Midland from four to three, and around Lufkin only two remain.
• No PPOs in the plans I checked. None of the 2027 marketplace plans in Houston, Midland, Lubbock or Lufkin was a PPO.
• West and East Texas pay more than Houston. In Houston, the benchmark silver plan for a 60-year-old rose about 13%, to about $1,420 a month. In Lubbock it is about $1,957 a month, about 38% above Houston and up about 18% from 2026. Around Lufkin it is about $1,809, roughly 27% above Houston.

If you’re retiring early in Texas

About 1.7 million Texans aged 55 to 64 have household incomes above four times the poverty level (Census, 2025), a rough measure of who earns too much for a marketplace subsidy. If you stop working before 65, you need your own coverage until Medicare starts, and if your spouse is younger than you, they may need a plan of their own after you move to Medicare. I’ll compare marketplace and private under-65 options for you or your spouse side by side. Private plans are medically underwritten, so approval isn’t automatic. Health insurance if you retire before 65

2027 marketplace prices checked November 1, 2026. Benchmark silver = the second-lowest-cost silver marketplace plan, for a 60-year-old non-smoker with no subsidy. Insurer counts are the companies offering marketplace plans in that county when I checked. These are the 2027 prices shown for open enrollment, and yours depend on your ZIP, age and plan.

Health insurance in Texas if you're self-employed or earn over the subsidy line

The short answer: above 400% of the federal poverty level, a Texas marketplace plan has no premium tax credit for 2027, and you pay the full price. For 2027 coverage that's about $63,840 for one person or $132,000 for a family of four, based on the 2026 HHS poverty guidelines (as of November 2026). Texas's final 2027 individual-market rates rose an average of about 14.6% before any subsidy, based on the approved filings (ACASignups weighted average, as of November 2026). Your own rate still varies by county and age, and as the Lubbock and Houston prices above show, the gap can be wide. I'll pull yours.

• Who this affects here. About 1.56 million Texans are self-employed (U.S. Census Bureau, 2025 American Community Survey), and about 492,000 self-employed people and small-business owners in Texas had marketplace coverage in 2023, according to a U.S. Treasury analysis of tax returns.
• Why the marketplace can look like the lower price until you cross the line. Texas marketplace sign-ups grew for 2026 while most states shrank, helped by a state pricing rule that makes some plans very low-cost for people who get a subsidy (KFF, as of November 2026). Above the subsidy line, that help doesn't reach you.
• How Texas is set up. Texas uses HealthCare.gov and has not expanded Medicaid (KFF). About 21.8% of Texans aged 19 to 64 were uninsured in 2025, the highest rate of the 31 states I'm licensed in (U.S. Census Bureau).
• Where to go next. If you're a freelancer with a spouse and kids to cover, see family coverage on self-employed income. Leaving a job? Compare COBRA and the alternatives, or see coverage for the stretch between jobs. To check where your income lands, read the 2027 ACA subsidy cliff explained.

I pick up my own phone, evenings and weekends too, which helps when your workday runs past five in Fort Worth or Austin. If a marketplace plan or the coverage you already have fits better, I'll tell you plainly and point you to the right help.

Figures as of November 2026. Sources: HHS 2026 poverty guidelines (400% line, multiplied out); U.S. Census Bureau 2025 American Community Survey and 2025 uninsured-rate report; U.S. Treasury Office of Tax Analysis (2023 marketplace coverage of the self-employed); KFF (2026 sign-up change, Medicaid expansion status).

Who I help across Texas

• Self-employed and 1099 contractors buying their own coverage
• Families and individuals shopping outside an employer plan
• People losing COBRA or between jobs who need coverage fast
• Small business owners covering themselves and their teams
• Truck drivers and owner-operators whose coverage has to travel with them (health insurance for truck drivers)
• Early retirees bridging the gap to Medicare

A Texas health insurance broker who's still there after you enroll

I'm Ryan Michalek, and I already work with clients across Texas, from Tarrant County to the Valley, all by phone and video. As a Texas health insurance broker, I'm not captive to one carrier, so I compare your real options and recommend what fits you. You get one licensed advisor from start to finish. That's me, Ryan Michalek, NPN 21043091, licensed in 31 states including Texas. You can confirm my Texas license yourself: the Texas Department of Insurance find a licensed agent page links to its agent lookup; search my name, Ryan Michalek.