Texas ACA Coverage in 2027: 7 Things to Check Before You Renew

1. Mark your Open Enrollment dates

The enrollment dates currently listed by HealthCare.gov are:

• November 1, 2026: Open Enrollment begins.
• Choose a plan by December 15 for coverage generally starting January 1, 2027.
• January 15, 2027: The final day of Open Enrollment. Selections made after the December deadline generally take effect February 1.

Outside Open Enrollment, you generally need to qualify for a Special Enrollment Period (SEP) to enroll or change Marketplace plans.

2. Don’t rely on automatic renewal alone

Automatic renewal is designed to help prevent a lapse in coverage. It does not mean the plan selected for you is necessarily the right fit.

Log in during Open Enrollment, update your projected 2027 income and household information, and compare the available plans. Premiums, benefits and provider networks can change each year.

Review your monthly premium, deductible, copays and coinsurance, out-of-pocket maximum, doctors and hospitals, and prescription coverage.

3. Some insurers are leaving the Texas Marketplace

The Texas Marketplace carrier lineup is changing for 2027.

As of this writing, Cigna and Baylor Scott & White are confirmed to be leaving the Texas individual Marketplace at the end of 2026.

If you currently have a Marketplace plan with either carrier, you will need a new plan for 2027. Even if HealthCare.gov automatically matches you with another plan, check:

• Whether your doctors and hospitals are in network
• Whether your regular prescriptions are covered
• Changes to the monthly premium
• Changes to the deductible and copays
• Changes to the out-of-pocket maximum

An automatically matched plan may not be the best fit for your needs. This year, comparing your options is especially important.

4. Review changes to immigration-related subsidy eligibility

For many immigrant families, this deserves special attention. Being eligible to buy Marketplace coverage is not the same as being eligible for financial assistance.

HealthCare.gov currently allows U.S. citizens, U.S. nationals and eligible lawfully present noncitizens to purchase Marketplace coverage.

Beginning January 1, 2027, CMS limits noncitizen eligibility for premium tax credits (PTC) and cost-sharing reductions (CSR) to three eligible noncitizen categories:

• Lawful permanent residents (green card holders)
• Cuban or Haitian entrants
• COFA migrants

People in these categories may still qualify for assistance if they also meet the applicable income and household requirements.

Some other lawfully present individuals may remain eligible to purchase coverage but no longer qualify for PTC or CSR. CMS’s 2027 training materials give refugees as one example.

People with refugee or asylee status, Temporary Protected Status (TPS), certain nonimmigrant visas such as H-1B or F-1, certain parolee categories, or other statuses outside the three eligible categories should review their eligibility carefully.

An employment authorization document (EAD) is not an immigration status. Two people with work permits may have different underlying statuses, so a work permit alone does not establish subsidy eligibility.

Eligibility can also differ within the same family. In CMS’s example of a wife who is a lawful permanent resident and a husband who is a refugee, both may purchase coverage in 2027, but assistance may apply only to the eligible wife’s portion of the premium. The husband may join the same plan while paying the full cost of his portion.

For mixed-status families, review each person’s eligibility separately rather than assuming one answer applies to everyone.

5. Look beyond the monthly premium

A lower premium does not always mean lower costs over the year. Compare the full picture:

• Deductible
• Copays and coinsurance
• Out-of-pocket maximum
• Doctor and hospital networks
• Prescription coverage

This is especially important if you see regular specialists, take ongoing medications, manage a chronic condition or expect to use more medical care.

6. Keep income and household details current

Marketplace savings are based on your estimated income and household circumstances for the coverage year—not simply last year’s numbers.

Update your expected income and household details during Open Enrollment. Outdated information can result in too much or too little financial assistance.

Report changes to income, marital status or household members as they occur.

7. Prepare documentation for a Special Enrollment Period

Losing coverage, moving, getting married or having a baby may qualify you for a Special Enrollment Period outside Open Enrollment.

Federal Marketplace SEP verification is becoming stricter for 2027. If you need to apply during the year, gather supporting documents early rather than waiting until the deadline.