A quarter of a million Tarrant County residents could face bills of hundreds of dollars more per month for health insurance next year.
Congressional reluctance to extend COVID-era tax credits for people covered by Obamacare policies under the Affordable Care Act has driven the price hike. Even if lawmakers eventually vote to keep the credits, insurance companies have already raised 2026 premiums to compensate for the expected impact of millions of healthy people dropping their suddenly more expensive Obamacare plans.
Percentagewise, this will be the biggest hike in Obamacare premiums since at least 2018.
“For a lot of people, when they look at the premiums, it’s going to be quite shocking,” said Simon Haeder, a professor of public health at The Ohio State University.
Texans will be more shocked than most. Average premiums in Texas will climb 35% for a mid-level silver Obamacare plan, compared to 26% nationally, according to a report from health policy research firm KFF. The reason is that Texas, unlike most states, has no statewide health insurance marketplace.
In dollars, the average premium for a 40-year-old individual Texan will increase $172 from $489 to $661 in 2025. That increase is baked into insurers’ announced 2026 rates and doesn’t include the potential effects of losing tax credits. If the credits aren’t available for 2026 policies, KFF estimates the average Obamacare premium will rise far higher, by an average of 114%.
The increase will be more for some insureds, especially older, higher-income people. For example, a 60-year-old Texas couple earning $82,000 a year could see premiums increase by more than 250% to $24,923 per year. That’s for a mid-level plan, according to a report from the Center on Budget and Policy Priorities.
Many enrollees already struggle to pay for insurance, and some will drop coverage if it gets much more expensive, said Lynn Cowles, director of health and food justice at Every Texan, an Austin health research and advocacy nonprofit.
“Estimates are that in Texas just over 1 million people will drop their plans,” Cowles said. “That will get us up around an uninsured rate of 19%, and we already have the highest percentage of uninsured.”
One problem with that is that healthy people are most likely to drop coverage, leaving Obamacare insurance companies with higher costs to treat sicker people. To protect profits, insurers anticipating the impact of ending tax credits have announced rate hikes that may remain in place, no matter what happens with the credits.
While insurers set the actual rates for Obamacare policies, many say the blame for the hikes lies elsewhere.
“The short answer is that it’s because Congress has failed to extend the subsidies that make insurance affordable,” Cowles said.
Partisan politics underlies the Congressional inaction. Republicans have refused to negotiate on credits until Democrats vote to temporarily fund federal government operations. Democrats, until recently, presented a united front insisting that tax credit extension must be part of any deal to end the government shutdown. However, some breakaway Dem lawmakers now say they will accept a promise to vote on the matter.
Although a deal to reopen the federal government now appears imminent, there is still no agreement to extend the tax credits or vote on the matter by a specific date. Credits may eventually be extended, at least temporarily, removing for the time being the main driver of higher insurance premiums. However, even if the credits are maintained and millions of healthy Obamacare enrollees don’t drop their coverage, it’s not clear whether insurance companies will or can roll back the higher premiums set in expectation of the end of tax credits.
The Congressional inaction directly impacts Tarrant County, where figures provided by Every Texas show 245,049 people are covered by Obamacare plans. Nationwide, 93% of Obamacare participants qualify for tax credits, so it’s likely that nearly every Fort Worthian using Obamacare is looking at the prospect of much higher insurance costs next year.
The effects on Tarrant County go beyond Obamacare enrollees, said Brandy Taylor Dédé, Dallas-based state director of the Children’s Defense Fund advocacy organization. She expects, for instance, that some parents will drop their own coverage while their children remain insured under another program, such as the federal Child Health Insurance Program for low-income families. But children will still suffer if a parent has untreated or very costly medical conditions, Taylor Dédé said.
More broadly, rural hospitals and clinics may stop offering services such as labor and delivery, or close altogether, under the financial pressure of having to provide care for uninsured people, she said.
“People think it’s just the person losing health coverage who will be impacted,” Taylor Dédé said, “but it affects all of us. When our neighbors can’t access affordable health care, we all end up bearing the burden of those costs.”
There’s one group of people who won’t be directly affected by expiring tax credits, Cowles said. Those people are undocumented immigrants.
“One huge piece of misinformation the federal government is sharing is that subsidies are going to undocumented people,” she said. “They are not. Undocumented people have never been eligible for assistance for health insurance.”
While Congress mulls its next move, Taylor Dédé urged Fort Worthians to contact their elected representatives in Washington, D.C., to express their concerns about the prospect of doubling health insurance premiums. Cowles said Obamacare enrollees should log onto Healthcare.gov, make sure their information is up to date, and be sure to cancel auto-enrollment. Otherwise, they’ll be automatically billed in January for the higher premiums, even if they’ve found another solution or decided to forgo coverage.
Other than that, it’s a waiting game to see how the partisan conflict in Washington plays out. With 2026 Obamacare coverage costs still unknown, current enrollees may want to keep their options open during open enrollment, which started Nov. 1 and ends Jan. 15, Haeder said.
“My advice would be to hold out as long as you can to get a January start date,” he added.
