Texas Health Insurance Marketplace in 2023
Key Points:
- 2.4 million Texans enrolled
- 15 insurance companies to choose from
- $0 deductible Silver plans available in every TX county
Changes in the cheapest Silver plans on the Texas health insurance marketplace:
- Monthly premium has gone up across Texas, by an average of 4%,
- Annual deductible amount has gone up by an average of $1,448,
- Maximum out-of-pocket amount has gone up on average by $187.
Does Texas Have a HealthCare Marketplace?
Yes, Texas has a healthcare marketplace. While it does not have a state-based health insurance marketplace, Texas uses the federally-run marketplace - HealthCare.gov, which offers state’s residents private insurance coverage that complies with the Affordable Care Act (ACA) requirements.
Who Is Eligible for Coverage Through the Texas Health Marketplace?
All residents of Texas are eligible for coverage on the federal health marketplace, as long as they are not incarcerated or already enrolled or eligible for Medicare or Medicaid.
How Many People Have Enrolled Through Texas’ Health Insurance Marketplace in 2023
During the open enrollment period of 1 November, 2022 - 15 January, 2023 - 2,410,810 Texas residents signed up for private individual and family health insurance coverage for 2023 through the federal marketplace.
Which Health Insurance Companies Offer Coverage on the Texas Marketplace in 2023?
In 2023, fifteen insurers offer health insurance plans to the residents of Texas through the federal health marketplace:
- Aetna (CVS)
- Ambetter / Celtic (Superior Health Plan)
- Ascension Personalized Care
- Blue Cross Blue Shield of Texas
- CHRISTUS
- Cigna
- Community Health Choice
- Imperial
- Moda
- Molina
- Oscar Health
- Scott & White Health Plan
- Sendero
- SHA (FirstCare)
- UnitedHealthCare of Texas
Notes:
- All health insurance plans sold on the marketplace exchange are compliant with the Affordable Care Act.
- Starting from 2023, Bright Healthcare and Friday Health Plans no longer offer health marketplace insurance to Texas residents.
Cheapest Silver Health Insurance Plans in Texas in 2023
The cheapest silver plans on the Texas health insurance marketplace have changed:
- Four of the companies that offered cheapest plans in some counties in 2022 are no longer the cheapest in any of the counties in 2023.
- Aetna CVS has expanded into 16 new counties.
- Ambetter, with its Balanced Care 30 plan, has more than doubled its market share of the lowest-priced silver plans (covering 51 counties, versus the 22 in 2022).
- Ascension, as the new entrant to the Texas health market in 2023, offers the lowest-cost plan in 5 counties.
- Baylor Scott & White grew the market share ten-fold.
- UnitedHealthcare expanded into 9 new counties as the lowest-cost option.
| Comparison of Cheapest Silver Plans Offerings by Company in Texas | ||
| Insurance Company | 2022 | 2023 |
| Counties | Counties | |
| Aetna CVS | 1 | 17 |
| Ambetter | 22 | 51 |
| Ascension | - | 5 |
| Baylor Scott & White | 10 | 103 |
| Blue Cross and Blue Shield of Texas | 154 | 50 |
| Bright Healthcare | 6 | - |
| CHRISTUS | 36 | 13 |
| Cigna | - | 4 |
| FirstCare Health Plans | 9 | - |
| Friday Health Plans | 12 | - |
| Oscar | 2 | - |
| UnitedHealthcare | 2 | 11 |
Note: Comparison is made using the cheapest Silver plan for a 35-year old individual.
How Did Individual Health Insurance Premiums Change in Texas in 2023
In 2023, the cost of the cheapest Silver plans in Texas has gone by an average of $18.67 compared with 2022. The largest increase was seen across Ambetter plans, which have gone by an average of $103.41 (25.6%). UnitedHealthcare plans increased by 16.2%, CHRISTUS by 19.8%, Baylor Scott & White - by 12.4%, and Blue Cross Blue Shield by 7.9%. Aetna CVS had the lowest price increase of all - around 5%.
The largest price premium increases for silver health plans in Texas were in the following counties: Baylor, Ford, Hardeman, Wilbarger, and Young.
| Comparison of Cheapest Silver Plans in Texas | ||
| Insurance Company | 2022 | 2023 |
| Average monthly price | Average monthly price | |
| Aetna CVS | $419.23 | $440.46 |
| Ambetter | $402.47 | $505.88 |
| Ascension | - | $483.24 |
| Baylor Scott & White | $427.73 | $481.18 |
| Blue Cross and Blue Shield of Texas | $498.86 | $538.39 |
| Bright Healthcare | $390.41 | - |
| CHRISTUS | $449.28 | $522.36 |
| Cigna | - | $427.70 |
| FirstCare Health Plans | $486.31 | - |
| Friday Health Plans | $385.72 | - |
| Oscar | $476.27 | - |
| UnitedHealthcare | $398.47 | $477.43 |
2023 Subsidies for Health Insurance in Texas
Since Texas uses the federal health insurance exchange, state’s residents receive subsidies and tax credits based on their expected earnings during the year. If you earn between 100% and 400% of the Federal Poverty Level ($14,580 - $58,320 for an individual, or $30,000 - $120,000 for a family of 4), you can get discounts on the cost of health insurance.
Speak with a Texas-licensed health insurance agent for more details.
How Did Individual Health Insurance Annual Deductible Change in Texas for 2023
In 2023, the annual health insurance deductible for the cheapest Texas plan increased across the state by an average of $1,475 (from $3,293 to $4,767).
In 64 of Texas counties, minimum deductible has gone down compared with the 2022 levels. In 20 counties the deductible went down by $200-$999. In 43 counties - $1,000-$2,900. While in 1 (Medina County) - deductible has gone down by $4,050 (from $6,100 in 2022 to $2,050 in 2023).
The lowest annual deductible stayed unchanged in 42 of the counties, and went up in 148.
For those looking for the plans with the lowest possible annual deductible in 2023, all Texas counties offer a $0 deductible plan, with an average cost of $583.80.
How Did Health Insurance Maximum Out of Pocket (MOOP) Change in Texas for 2023
The federally-set maximum out of pocket amount has increased from $8,700 (in 2022) to $9,100 in 2023. Some TX health plans offer lower options:
Comparing the lowest-priced SILVER plans across all Texas counties, individual MOOP has gone up by an average of $187. In 49 counties MOOP went down by anywhere between $300 and $1,300, compared with the 2022 level, with an average drop of $1,034. In 205 of Texas counties MOOP of the cheapest Silver plan has gone up, by a minimum of $200. In 11 counties MOOP of the cheapest silver plan went up by $2,800-$3,000.
The lowest possible MOOP on the cheapest TX Silver health plans in 2023 is $7,400 (offered by the AMBETTER Virtual Access Silver Plan). Meanwhile, BLUE CROSS BLUE SHIELD OF TEXAS Silver HMO 205, UNITEDHEALTHCARE Silver Virtual First, and CIGNA Connect 300, offer the lowest MOOP of $9,100.
Health Insurance Outside of the Texas Marketplace
Short term health insurance and other types of supplementary policies, other than Dental (which can be packaged with major health plans), cannot be purchased on the health care exchange in Texas, because they typically do not meet the minimum requirements of the Affordable Care Act. To shop for short term health, contact an insurance agent licensed in the state.
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