The federal government is about to reopen, but for Texas families, the bigger issue is still staring them right in the face. Those enhanced premium subsidies for ACA Marketplace policies are still going away. Texans didn't love the health policies they supported, but they relied on them to have some coverage options. That means higher premiums, thinner network coverage, and more frustration for middle-income households who already feel squeezed.
Across the state, families earning roughly $75,000 or more are being hit the hardest. The Affordable Care Act plans that used to feel “affordable enough” during the COVID relief years now cost hundreds more every month. To make things worse, plans available on the Health Insurance Marketplace in Texas are still an HMO. That means fewer choices when you actually need care.
So now the question is simple. If you’re facing a huge premium increase for a plan that limits your options, why stay with it?
The Shutdown’s Over, But Subsidies Are Still Gone
The end of the government shutdown doesn’t mean the plans available during the Open Enrollment Period are improving. The subsidy enhancements that were introduced during the pandemic were temporary, and those temporary premium tax credits have expired. That means real Texas families are seeing not only their premiums skyrocket, but the full cost of health benefits as well.
For many Texans, the math just doesn’t make sense anymore. They’re being asked to pay record-high prices for coverage they can barely use. Many are considering going without comprehensive coverage to make due. And some are going without it at all.
Why Going Without Health Insurance Is a Costly Gamble
When the renewal notice shows a big out of pocket premium increase, it’s natural to think about skipping coverage. But dropping your health insurance completely is a dangerous gamble.
If someone in your family ends up in the hospital, the costs can be devastating. A broken bone or a quick surgery can add up to tens of thousands of dollars before you even get home. A more serious illness or an extended stay can wipe out savings and leave a family in debt for years.
Some Texans think they’ll just pay cash if they ever need care, but that plan only works for health care costs like routine visits or smaller issues. Major medical events are a different story. Without any safety net, you are one accident away from losing what you’ve worked for.
The smarter move is to protect your family with coverage that fits your needs and your budget, instead of overpaying for an ACA marketplace plan that doesn’t deliver.
Smarter Options for Texas Families Tired of ACA Costs
The good news is that Texans do have better options. Private health insurance solutions outside of the ACA Marketplace can often provide the same or better protection at a more reasonable price. And they don't require a health insurance subsidy or premium tax credit.
Here are three paths that many Texas families are using right now to take back control of their health coverage and out of pocket costs.
1. Private PPO Health Plans
Private PPO health plans are making a comeback in Texas. These plans work the way health insurance used to. The provider network is robust, but you can also see any doctor or hospital you choose. The best news is that you don’t have to jump through hoops to get referrals to see specialists.
They downside is that they do require you to answer some basic health questions since they’re underwritten health plans. They are looking for major pre-existing conditions. But that also means you aren’t paying inflated premiums designed to cover everyone else’s medical costs. Healthy families often save thousands each year while gaining access to a broader network.
For many, it feels like getting back to real health insurance again.
Catastrophic Plans or Major Medical Coverage
Catastrophic health plans are built for the big stuff. They cover major illnesses, hospital stays, and surgeries that can wreck a family’s finances.
The premiums are typically much lower than ACA insurance programs because you’re insuring against life-changing events, not every small doctor visit. Many Texans pair these plans with cash-pay for routine care since local providers often offer clear, affordable pricing when insurance isn’t involved no matter your income level.
That combination gives you solid protection from major expenses without paying the high monthly cost of an ACA plan.
Hybrid Health Coverage Solutions
Hybrid coverage offers a flexible middle ground. These plans let you customize coverage for your family’s specific needs. You can include benefits for doctor visits, preventive care, hospital stays, or even critical illnesses.
They work by layering protection so you can create a plan that matches how your family actually uses healthcare. Many Texas families are choosing this route because it simplifies their coverage and reduces costs without sacrificing peace of mind.
Cash-pay rates for things like labs and imaging often cost less than what ACA insurance plans charge after copays and deductibles. That means these hybrid solutions give you both control and predictability in what you spend.
How to Choose the Right Fit for Your Family
If you’re comparing plans for 2026, take the time to look beyond what the ACA Exchange offers. Use this as your checklist:
- Are your preferred doctors and hospitals included in network?
- What will your total out-of-pocket costs be this year?
- Does this plan match how your family actually uses healthcare?
If you’re not sure how to make that comparison, that’s where help matters. Independent agents like the team at Insurance For Texans specialize in showing families the full picture of your health care options.
We walk you through ACA and private plan options side by side so you can see the total cost, coverage flexibility, and what each plan really offers.
You don’t need to figure it out on your own, and you definitely don’t have to settle for an overpriced ACA policy that doesn’t work for your family.
The Bottom Line
Even with the government reopening, nothing is changing about the cost of ACA health insurance. The enhanced subsidies are gone, the plans are still limited HMOs, and the premiums are climbing fast.
The good news is that Texans have options. Private PPO, catastrophic, and hybrid health plans are available right now and can replace ACA coverage for families who want better value and more freedom.
If your ACA premium feels like another mortgage payment, it’s time to look at alternatives that protect your family and your wallet.
Click the button below to explore private health insurance plans that fit your family, your budget, and your Texas lifestyle.