How health insurance works in Texas
Texans buying their own coverage have two markets: HealthCare.gov (healthcare.gov), where plans from Blue Cross Blue Shield of Texas, Ambetter, Oscar, and Baylor Scott & White are guaranteed-issue and priced on income, and the private shared-network market, where PPO plans on Cigna, Aetna and PHCS PPO are underwritten and priced on age and health.
Medicaid is not expanded in Texas. Texas has no state individual mandate and no state penalty for going without coverage.
What it costs
Full-price marketplace plans for a 40-year-old in Houston commonly run $550–$850 a month in 2026; with a subsidy, often under $300. Private PPOs for the same healthy person run roughly $320–$480. Texas has no state income tax, so the self-employed health insurance deduction only reduces your federal bill — which makes the premium itself the number to attack.
The Texas picture
Texas has the highest uninsured rate in the country, and because Medicaid wasn't expanded, adults under the poverty line fall into a coverage gap with no subsidy at all.