Episcopal Health Foundation conducted an analysis of recently released ACA enrollment data for Texas from the Centers for Medicare & Medicaid Services for the Health Insurance Marketplace’s 2021 open enrollment period (OEP). In this report, we examine the new enrollment data from the 2021 OEP, November 1, 2020 through December 15, 2020, and compare it to data from the first seven OEPs. We also discuss the implications of the latest ACA enrollment data in Texas in the larger contexts of the unprecedented COVID-19 crisis, recent federal policy changes in the ACA marketplace and state health policy reform.