Health care premiums may skyrocket for millions of Texans as tax credits expire

TEXAS - Health care costs are poised to climb for millions of Americans, and data shows costs for Texans will likely be well above the national average.

The enhanced premium tax credits that kept plans affordable are set to expire at the end of this year, and if Congress doesn't extend them, premiums are set to skyrocket next year.

Texas healthcare prices may rise

What we know:

Texas is one of 10 states that did not expand Medicaid back in 2012, which means millions in the state rely on buying private plans through the federal marketplace. 

And as people prepare to renew their coverage for 2026, analysts warn of true "sticker shock." Open enrollment for health insurance begins Saturday, Nov. 4, and with enhanced federal tax credits about to expire, next year's costs are expected to soar.

According to the Texas Association of Health Plans, average premiums, nationwide, are projected to climb roughly 75 percent. Here in Texas, it's expected to top 115 percent. That means the average monthly cost for a family is forecasted to jump from $1,600 to more than $3,400.

Roughly 3.3 million Texans buy insurance on their own. Close to a million gained coverage only because of the expanded tax credits. And experts fear without that financial help, many will drop coverage altogether.

‘The die is already cast’

What they're saying:

"When those tax credits go away, those Texans that were able to come into the market and get that affordable coverage, they're gonna find that their coverage is now a lot more expensive, in most cases about double," said Blake Hutson with the Texas Association of Health Plans. 

"Even though there’s still debate on whether we’ll extend or renew the enhanced premium tax credits, the die is already cast. The insurance carriers, with that uncertainty, had to look at what their premiums would be," said Stephen Love, president and CEO of the DFW Hospital Council.

Hutson says the number of those with insurance in Texas has climbed since the launch of the tax credits. 

"Prior to those tax credits, about a million Texans got coverage in that marketplace. Now it's about four million, and that's simply because the tax credit has made that monthly cost for a family much more attainable," Hutson said.

Texas already leads the nation in the number of uninsured residents, with about 17 percent. Officials warn that will likely rise above 20 percent, because Texans won't be able to afford it.  

"That means when you walk down the street, every fifth person you see has no health insurance," Love said.

"That's going to overcrowd emergency rooms. You're getting primary care in the wrong setting. The hospitals are probably not going to collect or get reimbursed for that," Love continued.

What you can do:

For now, Texans are urged to shop carefully during open enrollment to see if any remaining tax credits can still help keep plans within reach.

"You may still find a plan that’s affordable for you. There are still tax credits that do exist. So put your family information in there and check it out."

What's next:

Open enrollment runs through Jan. 15. 

Those higher prices won’t show up until the 2026 plan year, unless Congress steps in to renew those tax credits.