Health insurance in Texas for 2027

Cigna. In its quarterly report for the period ending June 30, 2026, The Cigna Group says that in April 2026 it “announced its planned exit from the Individual and Family Plans medical business as of January 1, 2027.” (The Cigna Group is a separate company from the Cigna insurance companies that issue these plans, and it isn’t responsible for their financial condition or their obligations under their policies.) Cigna’s own page for individual and family plans says Cigna Healthcare “will no longer offer Individual and Family medical plans as of January 1, 2027” and that “These plans cannot be purchased, renewed, or continued for 2027.” It names Cigna HealthCare of Texas, Inc. among the companies that insure them, points Texas shoppers to HealthCare.gov, and says its individual and family dental plans aren’t affected. Cigna HealthCare of Texas, Inc. is on CMS’s list of 2026 Texas rate filings and not on its 2027 list. This is about plans you buy for yourself, not coverage through an employer.

In 2026, Cigna sold HealthCare.gov plans in 11 of Texas’s 254 counties: Collin, Crosby, Dallas, El Paso, Ellis, Hunt, Johnson, Kaufman, Lubbock, Rockwall and Tarrant. They’re HMO plans from Cigna HealthCare of Texas, Inc., shown on HealthCare.gov as Cigna Healthcare. In each of those counties, between two and eight other companies that sold HealthCare.gov plans there in 2026 have filed 2027 rates that include HealthCare.gov plans. Kaufman has the fewest: two, Blue Cross and Blue Shield of Texas and WellPoint. A rate filing doesn’t say which counties a company will sell in, so check your county’s 2027 list on HealthCare.gov once open enrollment starts.

Baylor Scott & White. Baylor Scott & White Health Plan says on its website that it “notified regulators of its intent to discontinue Individual & Family Marketplace plans after Dec. 31, 2026,” and that nothing changes in your coverage until then. That’s its Marketplace plans; its page doesn’t say anything about Medicare or employer plans. The health plan ending doesn’t mean the hospitals and doctors are leaving: its page says “Baylor Scott & White Health will continue to accept Individual & Family Marketplace plans,” and tells you to check that your doctor is in your new plan’s network. In 2026, its HealthCare.gov plans were HMO plans from Scott and White Health Plan, in 104 of Texas’s 254 counties. The two Baylor Scott & White companies that filed 2026 Texas rates, Baylor Scott & White Insurance Company and Scott and White Health Plan, aren’t on CMS’s 2027 list. Its page says to choose a new plan from November 1 to December 15, 2026. HealthCare.gov says open enrollment runs through January 15, 2027 (below). Either way, December 15 is the date for a plan that starts January 1.

Your letters. If your plan came through HealthCare.gov, HealthCare.gov says you should get two letters by November 1: one from your insurance company, and one from the Marketplace, which is HealthCare.gov itself. The insurance company’s letter should say whether your plan is available for 2027 and, if it isn’t, whether the company is offering a similar or alternate plan. Together, HealthCare.gov says, the two letters tell you which plan, if any, you’ve been matched with. The Marketplace’s letter also tells you anything you need to do to keep getting a tax credit. Keep both.

If you don’t pick a plan. HealthCare.gov says: “If your company isn’t offering plans for next year, we’ll re-enroll you in a plan with a different insurance company. Your plan doesn’t start until you pay your first monthly premium.” So if that happens, watch for the new company’s first bill and pay it. The federal rule leaves the choice to your state’s insurance regulator first, and I haven’t found any direction from the Texas Department of Insurance. Without one, CMS’s enrollment manual of October 1, 2026 says HealthCare.gov looks for a similar plan in your area, at the same level (like silver) and of the same network type (like HMO) where it can, and weighs which company can take on new members and which plan costs least. It doesn’t check your doctors or your prescriptions. HealthCare.gov also says that in some cases you won’t be re-enrolled at all. That’s why I’d rather you pick.

If you bought your plan outside HealthCare.gov, HealthCare.gov won’t move you. It re-enrolls only people it enrolled, and CMS’s standard letter for a plan ending off HealthCare.gov says to pick a different plan by a set date or go without coverage. You can pick one on HealthCare.gov or off it, but only a plan bought through HealthCare.gov can come with a tax credit.

If you miss December 15. Because your plan is ending, you also get a special enrollment period: 60 days before and 60 days after your coverage ends to pick a new plan. Under the federal rule, a plan you pick before your coverage ends starts the first day of the month after it ends, so one picked by December 31 would start January 1; pick later and it starts the month after you pick. You may be asked for documents showing the loss, within 30 days of picking, and if you’re new to HealthCare.gov, CMS says you’ll have to send them before you can use the plan. If you’re already on HealthCare.gov, it may only let you choose from your current plan category, like bronze or silver. December 15 is simpler.

What I’d do now:

• Watch for those two letters and keep them. If you’re asked for proof, you’ll need “documents showing the lost coverage and the date it ends,” in HealthCare.gov’s words.
• Write down your doctors, your hospital and every prescription you take.
• Update your 2027 application on HealthCare.gov, income included. HealthCare.gov says that when the application asks whether you’re losing coverage, you should say you’re losing it on December 31.
• When 2027 plans show up on HealthCare.gov, check each one you’re considering for your doctors and drugs, including any plan you’re matched with, and call your doctors’ offices to ask whether they’ll take that plan in 2027.
• Pick your plan by December 15, and pay the new company’s first bill, so it starts January 1.

Texas uses HealthCare.gov. For plan year 2027, CMS lists Texas as a federally facilitated marketplace state. I help people in Texas enroll through HealthCare.gov and HealthSherpa.

Open enrollment starts November 1, 2026. A plan you pick by December 15 starts January 1, 2027. A plan you pick from December 16 through January 15, 2027 starts February 1.

The January 15 end date is contested. CMS gives that date, and so do HealthCare.gov’s dates page and CMS’s enrollment manual of October 1, 2026. A federal rule finalized in June 2025 would have ended open enrollment on December 15 instead. A federal district court threw out that part of the rule in June 2026, the government appealed, and the appeals court set argument for October 30, 2026. Until a court changes them, CMS’s dates are the ones that count. My 2027 open enrollment guide follows the case.

These are the 17 companies whose 2027 Texas individual-market rate filings are on CMS’s rate review site, as I read it on October 27, 2026. I’ve left out the prices they asked for, because those were requests. The Texas Department of Insurance reviews these filings, and CMS has recognized its reviews as meeting federal standards since the 2023 plan year.

Eighteen companies sold HealthCare.gov plans in Texas in 2026, by CMS’s 2026 plan file. Sixteen of them have 2027 filings on CMS’s list that include HealthCare.gov plans; Cigna and Baylor Scott & White are the two that don’t.

If you have an Ambetter plan on HealthCare.gov, the first row isn’t yours. Ambetter Health of Texas Inc sold no HealthCare.gov plans in 2026, and its 2027 filing is only for plans sold outside HealthCare.gov, so they can’t come with a tax credit. The HealthCare.gov plans shown as Ambetter from Superior HealthPlan in 2026 came from Celtic Insurance Company and Superior Health Plan, and both have filed 2027 rates that include HealthCare.gov plans. Your renewal letter will say which company your plan is with.

Besides Cigna and Baylor Scott & White, one other company with a 2026 Texas filing, Access to Care Health Plan, isn’t on CMS’s 2027 list. Its 2026 filing was only for plans sold outside HealthCare.gov. I found no announcement that it’s leaving, and CMS only lists filings that change rates, so a missing name isn’t proof.

When I read the site, every filing was marked “Pending Review.” CMS doesn’t update that list until it posts final rates, which it said it planned to do by October 30, 2026.

The tax credit that lowers your monthly premium is still there for 2027, for a plan you buy through HealthCare.gov. Between the poverty line and four times it, the credit is figured from what your area’s benchmark plan, the second-lowest-cost silver plan, costs compared with a set share of your income. When benchmark prices go up, the credit goes up with them, though other plans’ prices can move by more or less. There’s a cap again for 2027: if your household makes more than four times the poverty line, you won’t get any credit. That’s $63,840 for one person, $86,560 for two, $109,280 for three and $132,000 for four. And starting with 2027, fewer people who aren’t U.S. citizens qualify.

Texas hasn’t expanded Medicaid under the Affordable Care Act, so Medicaid here covers set groups of people, not every adult under an income line. The groups include children, pregnant women, some parents and caretakers of a child, young adults 18 through 25 who were in Texas foster care, and some others. Applying is how you find out which group, if any, you fit. The limit for parents is very low: for one parent in a family of three, $230 a month, a figure the Texas Health and Human Services Commission’s handbook has used since October 2015. For a pregnant woman in a family of three, the limit is $4,508 a month (effective April 1, 2026).

That leaves a gap, because the tax credit for a HealthCare.gov plan starts at the poverty line. For 2027 coverage, the poverty line is $15,960 a year for one person, $21,640 for two, $27,320 for three and $33,000 for four. HealthCare.gov puts it plainly: if your state hasn’t expanded Medicaid, your income is below the poverty line and you don’t qualify for Medicaid under your state’s rules, “you won’t qualify for either health insurance savings program.” It still says you should fill out a Marketplace application. HealthCare.gov bases the credit on your expected income for 2027 and asks for your best estimate. Make it an honest one: if your income ends up different, HealthCare.gov says you could have to pay money back when you file your taxes.

Healthy Texas Women is a separate program with limited benefits: family planning exams and counseling, birth control (not emergency birth control), and treatment of certain sexually transmitted infections. It’s for women 15 through 44 who aren’t pregnant, have income up to 204.2% of the poverty line, and don’t have other insurance that covers family planning. It isn’t full health coverage.

You can apply for Texas Medicaid any time of year, online at YourTexasBenefits.com or by calling 2-1-1.

If you aren’t a U.S. citizen, check before you count on Medicaid or the tax credit. In a policy bulletin, the Texas Health and Human Services Commission says that beginning October 1, 2026, Medicaid and CHIP are limited to U.S. citizens and nationals, green card holders, Cuban and Haitian entrants, and citizens of the Marshall Islands, Micronesia and Palau living here under their compacts. Green card holders admitted after August 22, 1996 must also wait five years and have 40 qualifying quarters of Social Security coverage to get Medicaid, unless an exception applies. Lawfully residing children keep Medicaid and CHIP, and Emergency Medicaid isn’t affected. Starting with 2027 coverage, the tax credit is limited to the same four groups, with no separate rule for children.

Children 18 and younger can get children’s Medicaid or CHIP, depending on family income. Children’s Medicaid is free. CHIP covers children in families that earn too much for Medicaid, up to 201% of the poverty line: $4,577 a month for a family of three, or $5,528 for a family of four, in the Commission’s limits effective April 1, 2026. CHIP has a yearly enrollment fee of $0, $35 or $50 for the whole family, depending on income. Copays depend on income too. In the Commission’s handbook, a doctor visit costs $5, $20 or $25, a generic prescription $0 or $10, and checkups and shots nothing. Total cost sharing is capped at 5% of the family’s income for the coverage period. Once a child is on CHIP, coverage generally lasts 12 months, and if you send in the renewal form before then, the Commission keeps it going until the renewal is finished.

You can apply any time of year, at YourTexasBenefits.com or by calling 2-1-1. In the Commission’s words: “When you apply, we’ll ask about your family’s income to see which programs your child can get.” Above CHIP’s limit, your children can be on your HealthCare.gov plan, where the tax credit can help pay for their coverage too.