Getting Covered in Texas
Medicaid, CHIP, the Marketplace, Medicare, and the gap between them.
- Medicaid for Bills From Before You Applied: The Three Months Prior Rule in Texas
September 8, 2026
Texas Medicaid can reach back three months before the month you applied, if you qualified then and the bill is unpaid. Form H1113, who it reaches, and 2027.
- Coverage If You Lose Your Job in Texas: COBRA Against a Marketplace Plan
July 17, 2026
Losing job-based coverage opens two doors at once: COBRA and a Marketplace special enrollment period. How Texans work out the arithmetic between them.
- Medicare Basics for Texans: Turning 65 Without Coverage
July 9, 2026
Turning 65 uninsured in Texas: Parts A to D, the enrollment windows that carry lifetime penalties, and where the Medicare Savings Programs are decided.
- Short Term Plans and Health Shares: What Texas Regulators Say They Are Not
July 2, 2026
TDI's warning in plain terms: short-term plans, discount cards, and health care sharing ministries are not coverage, and often not regulated at all.
- Cost Sharing Reductions: The Silver Plan Rule and Why Bronze Can Cost More
June 25, 2026
Cost sharing reductions only attach to Silver plans, which is why a cheaper Bronze premium can leave a Texas household worse off across a whole year.
- Picking a Marketplace Plan in Texas: Deductible, Network, Formulary, Traps
June 16, 2026
Deductible against premium, network checks, drug formularies: the plan comparison steps that decide what a Texas Marketplace policy really costs you.
- Special Enrollment Periods: Getting Covered Outside Texas Open Enrollment
June 10, 2026
Missed open enrollment? A qualifying life event can still open the Marketplace. What triggers one in Texas, the proof requested, and where the deadlines sit.
- How Marketplace Subsidies Work: The FPL Band, the Benchmark Plan, and Tax Time
May 29, 2026
Premium tax credits run from 100% to 400% FPL again for 2026. The benchmark plan, the FPL band, and the reconciliation that catches people at tax time.
- Marketplace Plans in Texas: What Is Sold Here and How to Read It
May 22, 2026
What is actually sold on the Texas Marketplace: metal tiers, narrow networks, and how to read a plan you have no way to test drive before you buy it.
- CHIP and Children's Medicaid in Texas: The Age Bands That Decide Which One
May 12, 2026
Children's Medicaid runs to 198% FPL for infants and CHIP to 201%. How HHSC's age bands decide which of the two programs a Texas household lands in.
- Medicaid for Pregnant Women in Texas: The Limit, the Coverage, the 12 Months
May 11, 2026
Medicaid for Pregnant Women reaches 198% FPL on HHSC's chart, and coverage runs 12 months after the birth. What the pathway covers and how to apply.
- Texas Medicaid Eligibility: The Categories That Exist, and the Ones That Do Not
May 5, 2026
Category first, income second: how Texas Medicaid eligibility really works, the limits HHSC publishes, and the adult pathway this state never created.
- Why Texas Did Not Expand Medicaid: The History, and What Expansion Would Change
April 21, 2026
Ten states have not adopted the ACA Medicaid expansion and Texas is one. The policy history without a side, and what expansion would actually change here.
- The Texas Coverage Gap: Why Reapplying With the Same Income Changes Nothing
April 15, 2026
Too much for Medicaid, too little for a subsidy: about 605,000 Texans sit in the coverage gap, and reapplying next year with the same income changes nothing.
- Health Coverage in Texas: Every Route In, and Who Falls Between Them
April 13, 2026
Texas has the highest uninsured rate in the country at 16.7%. Every route to coverage here, who each one is for, and who none of them reach.