Twelve years of data tell a clear story—the Affordable Care Act’s (ACA) health insurance marketplace has played a crucial role in reducing the number of uninsured Texans.
The latest enrollment numbers for 2025 show that almost 4 million Texans – a new record – signed up for ACA health insurance. That’s more than double the number of Texans who enrolled just three years ago.
A new research brief from EHF’s Shao Chee Sim and Elena Marks at Rice University’s Baker Institute for Public Policy finds that in just the past four years, state and federal policy changes like enhanced tax credits, increased subsidies, and funding for navigators helped a record number of Texans access affordable health coverage.
But what’s next?
The report shows that policymakers have an opportunity to build on this progress and make sure even more Texans can get the health insurance they need.
“By renewing enhanced premium tax credits and investing in outreach efforts, policymakers can ensure continued access to health insurance for millions,” the report says. “The decisions made in 2025 will shape the future of health coverage in Texas, determining whether the progress achieved over the past decade is sustained or reversed.”
