Texas Bucks National Trend, Sees ACA Enrollment Surge

Texas leads the nation in Affordable Care Act plan selections for 2026, even as enrollment declines elsewhere

Published on Feb. 10, 2026

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Final open enrollment figures show that close to 4.2 million Texans enrolled in an Affordable Care Act (ACA) plan for 2026, exceeding the state's 2025 enrollment of just under 4 million and representing an increase of more than 200,000 enrollees year-over-year. This growth comes as ACA enrollment declined across the country, with losses spread across most states.

Why it matters

Texas' robust ACA enrollment numbers stand in stark contrast to the national trend, highlighting the state's unique health insurance market. Bipartisan state-level regulation has helped optimize consumer value in the ACA marketplace, making coverage more affordable for Texans compared to other states.

The details

While the national ACA enrollment declined by nearly 1.2 million, Texas posted the largest numerical gain in the country and one of the highest percentage gains. Among the 12 largest states, only a handful saw enrollment growth at all, with states like Florida, Georgia, North Carolina and Ohio experiencing declines ranging from tens of thousands to well over 200,000. Texas not only gained enrollees, it did so at a scale far beyond its peers.

  • Final open enrollment figures for 2026 ACA plans were released on February 2, 2026.
  • Texas' 2026 ACA enrollment of 4.2 million exceeded the state's 2025 enrollment of just under 4 million.

The players

Charles Miller

Texas 2036's Health and Economic Mobility Policy Director, who stated that Texas has one of the best ACA markets for consumers due to bipartisan state-level regulation to optimize consumer value.

Nathan Johnson

A Democratic state senator who co-authored a 2021 bipartisan law that ensures Texans benefit more from ACA subsidies than in many other states.

Tom Oliverson

A Republican state representative who co-authored the 2021 bipartisan law that helps make ACA plans more affordable for Texans.

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What they’re saying

“Texas has one of the best ACA markets for consumers. That is due, in large part, to bipartisan state-level regulation to optimize consumer value.”

— Charles Miller, Texas 2036's Health and Economic Mobility Policy Director (EINPresswire)

What’s next

Texas officials will continue to monitor effectuated enrollment figures, which may settle lower than the initial plan selection data, but are still expected to outperform national trends.

The takeaway

Texas' exceptional ACA enrollment growth, even as the rest of the country saw declines, underscores the state's unique health insurance market and the success of bipartisan efforts to make coverage more affordable for consumers.