By RJ Morales | TX3DNews
Millions of Texans who buy health insurance through the Affordable Care Act (ACA) marketplace are getting an early look at what 2026 could cost — and for some, the projected prices are far higher than what they pay today. As insurers begin setting rates for next year, many are doing so under current law, which schedules enhanced federal subsidies to end after 2025, bringing potential premium increases into focus across Texas’ 3rd Congressional District.
The Affordable Care Act itself is not set to expire. What is at issue are temporary premium tax credits that reduced monthly costs and expanded eligibility for financial assistance. Unless Congress acts, those enhanced credits will end after the 2025 plan year.
Heavy reliance on subsidized coverage in TX-03
Texas remains one of the nation’s largest Affordable Care Act marketplace states, with nearly four million plan selections during the most recent open enrollment period, most supported by advance premium tax credits.
Federal estimates from CMS’ 2024 Open Enrollment Public Use Files show roughly 77,000 marketplace plan selections in Texas’ 3rd Congressional District, the majority tied to subsidies. County-level data similarly indicates heavy reliance on federal financial assistance in Collin County, the population center of TX-03.
Health policy analysts say that if the enhanced subsidies expire, average net premiums would rise for many marketplace enrollees, though the impact would vary by age, income, plan type, and location. Insurers have indicated that uncertainty over subsidy policy is already being factored into early pricing assumptions for 2026 plans.
Estimates showing sharp increases
For some residents, those changes are already appearing in premium estimates.
Maria, a Collin County woman in her late 50s, who works full time and asked to be identified only by her first name, said she has relied on ACA coverage for the past three years after spending decades uninsured. Screenshots she shared with TX3DNews show her current monthly premium at $41.01.
A 2026 estimate from her insurer lists the cost of keeping the same plan at $1,409.51 per month. A HealthCare.gov search she provided showed the lowest-priced plan available to her at $863.57 per month.
The figures reflect estimates displayed by insurers and the federal enrollment website and could change based on income projections, subsidy eligibility, plan availability, or congressional action. Still, she said the projected increase has left her uncertain about whether she could remain insured. “I don’t see how this works if the prices go where they’re being shown,” she said.
She said having coverage allowed her to seek care earlier rather than delaying treatment due to cost. “It was so nice being able to see a doctor before things turned into something more serious,” she said.
Coverage continuity concerns
Another TX-03 resident, Marc, said ACA coverage was critical while he underwent cancer treatment this year.
Marc said he recently completed chemotherapy and radiation while insured through a marketplace plan. When reviewing 2026 renewal information, he said the projected cost of keeping the same private plan reflected a 94 percent increase before subsidies, based on current estimates.
Because ACA premium tax credits are calculated using projected annual income, Marc said he lowered his expected income for 2026 due to uncertainty about ongoing treatment, which increased the subsidy available to him and reduced the estimated premium. He said he remains concerned about the ACA’s income reconciliation process, which can require enrollees to repay some subsidies if their actual income ends up higher than projected.
For Marc, the issue extends beyond cost. “During treatment, losing coverage or having to switch plans isn’t just a financial decision,” he said. “It affects access to doctors, medications, and continuity of care.”
Reader feedback echoes concerns
Similar concerns appeared in reader feedback submitted to TX3DNews. In a comment left on the site, a Collin County resident who identified himself as a disabled veteran said affordable healthcare is essential to daily stability for people managing long-term medical conditions.
He wrote that reliable coverage allows disabled residents to remain independent and seek care earlier rather than delaying treatment due to cost. He also urged residents to pay closer attention to how healthcare policy decisions affect veterans and people with disabilities, noting that reductions in healthcare support can have immediate consequences for those who depend on consistent access to medical services.
What happens next
Whether the enhanced subsidies are extended remains an unresolved federal policy decision. Supporters say the credits helped drive record marketplace enrollment, while critics cite federal cost concerns.
Under current law, the enhanced subsidies are set to expire after the 2025 plan year, affecting coverage beginning in 2026. Insurers are expected to finalize 2026 rates later this year, which could provide clearer information for consumers.
In the meantime, enrollment experts advise marketplace consumers to review renewal notices carefully, compare plans during open enrollment, and monitor federal developments that could affect subsidy eligibility and premium costs.
Editor’s note: TX3DNews reviewed screenshots and written comments provided by residents quoted in this article. Premium figures reflect estimates displayed by insurers and HealthCare.gov based on individual inputs and assumptions and may change depending on income, plan availability, or congressional action.