San Patricio County, TX
Obamacare By Zipcode
What Texas Residents Need to Know About Obamacare for 2023
Texas open enrollment for 2023 health insurance plans runs from November 1, 2022 until January 15, 2023.
This website provides information about getting health insurance under the Affordable Care Act (ACA), including:
- whether you must get health insurance
- what the available plans cover
- how much coverage will cost
- how to sign up for a plan
- how to get help if you need it.
To begin, keep in mind these key points about health insurance in Texas:
1. Open enrollment for 2023 health insurance plans runs from Tuesday, November 1, 2022 through Sunday, January 15, 2023.
Texas residents can sign up for 2023 health coverage from November 1, 2022 to January 15, 2023. For most people, if you enroll by December 15, your coverage will begin on January 1, 2023. If you enroll after December 15, your coverage will start on February 1.
Enrollment for 2022 health coverage has ended, but you can get covered for the rest of the year if you qualify for a special enrollment period, including job or income loss.
If you're uninsured, you can use Healthcare.gov to compare plans and enroll in a plan that meets your needs.
If you already have health insurance, you will be automatically re-enrolled in your existing plan if it is still available. Even if your plan is continuing, open enrollment is an excellent time to review your coverage, compare plans, and switch to a new one if you find a better option. If your insurance company stops offering your current health plan, they may "map" you onto a new plan. In this case, it's vital that you to investigate your options to be sure you get the best plan for you.
To learn more about enrollment, see How To Sign Up for Obamacare in Texas.
2. You won’t face a tax penalty for going without health insurance in 2023—but there are big downsides to being uninsured.
Obamacare’s tax penalty went away in 2019. That means that if you don’t have health insurance, you won’t have to pay a penalty when you file your federal income taxes. That said, think about whether it makes sense to forego health insurance. A medical crisis could knock the financial wind from your sails and do more damage than the penalty. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.)
In 2021, President Biden signed the American Rescue Plan Act (ARPA). The law provided $1.9 trillion of federal aid to Americans struggling with the COVID-19 crisis, including additional premium subsidies for those who purchase health insurance through Healthcare.gov. In 2022, the Inflation Reduction Act extended these more generous subsidies through 2025. Here’s a quick summary of the types of available subsidies.
Federal tax credits. Under ARPA, no one will have to pay more than 8.5% of their household income for a mid-level plan purchased from Healthcare.gov. Technically, the subsidies are tax credits, but you can choose to have them automatically deducted from the cost of your monthly premiums.
Cost-sharing subsidies. More than half of the people who purchase coverage through Healthcare.gov receive assistance through cost-sharing reductions (CSRs). CSRs automatically reduce your premiums and lower your costs when you use your insurance benefits—for example, when you go to the doctor, get lab work, or have to stay in the hospital.
CSRs are available to people who make between 100% and 250% of the federal poverty level. (For 2023 health plans, that means a family of four in Texas can't earn more than $69,375 and an individual not more than $33,975.) But these benefits are available only on silver plans. If you think you may qualify, look carefully at the costs for silver plans available at Healthcare.gov while shopping for coverage.
Medicaid. You may qualify for free or low-cost coverage through Medicaid in Texas if your income is very low.
All subsidies will be automatically calculated when you apply for a plan through Healthcare.gov.
For more information, see Ways to Save Money on Obamacare in Texas.
4. Average premium rates are going up, but that doesn't mean you'll pay more.
Nationwide, the average rate increase for 2023 health plans will be about 7.7%. However, these numbers aren't final and, more importantly, this doesn't tell you how much you'll pay for health insurance. Costs vary from state to state and plan to plan within a state. For example, Texans are looking at an average premium increase of more than 8% while Virginians, generally, will benefit from an average decrease of about 13%. Also, if premiums for the benchmark plan (the plan used to determine subsidy amounts) go up, subsidies will go up, too. This is a long way of saying don't let the numbers scare you. Comparison shop at Healthcare.gov to find the plans and subsidies available to you.
5. Try to avoid short-term insurance plans that don’t comply with the ACA.
In 2018, the Trump administration made it easier to purchase "short-term insurance plans." Short-term plans don’t have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. In the past, short-term plans were allowed to last only three months but under new rules, you can purchase a non-ACA-compliant “short-term” plan that lasts as long as three years.
If you’re genuinely caught without health insurance and need it for a few months to cover a new health condition, you might want to consider a true short-term plan to get you through to the next open enrollment period. Otherwise, be careful of plans that don’t meet the requirements of the Affordable Care Act, and shop around to look for coverage that truly meets your needs.
Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in Texas.
6. You can get help signing up if you need it.
The Biden administration has greatly increased enrollment assistance, making it much easier to get the information you need to get covered. To connect with local support resources, see How To Sign Up for Obamacare in Texas.
Learn about the 2023 rates for Obamacare in San Patricio County.
Texas Obamacare Law
What Texas Residents Need to Know About Obamacare for 2023Essential facts about the Affordable Care Act (ACA or Obamacare) in Texas, including whether you must get health insurance, how much it costs, and how you can save money.
Texas Medicaid Expansion: Do I Qualify for Medicaid Under the ACA?Not all states have expanded Medicaid coverage under the Affordable Care Act. Learn where Texas stands.
What is Obamacare and the Affordable Care Act?Obamacare is another name for the federal Affordable Care Act (ACA) which was signed into law by President Barack Obama in 2010.
What do Obamacare health insurance plans cover?All ACA health insurance plans must include certain "essential benefits."
Do I Have to Get Health Insurance in Texas in 2023?Learn whether you must have health coverage under the Affordable Care Act (Obamacare) in Texas.
San Patricio County, TX 2023 Obamacare RatesObamacare Rates for all Counties served by the Federal Exchange
How Much Does Obamacare Cost in Texas?Learn the five factors that determine what residents of Texas will pay for health insurance under the Affordable Care Act
How Much Does Obamacare Cost in Texas?Learn the five factors that determine what residents of Texas will pay for health insurance under the Affordable Care Act.
How Much Is the Obamacare Tax Penalty in Texas for 2023?The Affordable Care Act (Obamacare) tax penalty has been set to zero, but some states have enacted their own health insurance requirements.
How To Sign Up for Obamacare in Texas for 2023Where to go in Texas to get health plans under the Affordable Care Act (Obamacare) and how to get help with the application process.
Can I Use a Paper Application to Get Obamacare?If you want to apply for Obamacare (the Affordable Care Act) using a paper application, you can. Here's how to find the forms for Texas.
Where can I get in-person help with my application?You can get free sign-up help from a trained enrollment counselor or certified insurance broker in Texas.
Information & Documents to Have on HandGather this information before you apply for health coverage under the Affordable Care Act.
How an Insurance Agent or Broker Can Help You Sign Up for Obamacare in TexasA licensed insurance agent or broker can help you compare plans, figure out whether you qualify for subsidies, and apply for coverage in Texas.
What Happens If I Missed the Texas Obamacare Enrollment Deadline for 2022?If you miss the Affordable Care Act (Obamacare) deadline in Texas, you may still be able to get covered.
Texas Obamacare Scams: What They Are & How to Avoid ThemScammers are trying to take advantage of consumers confused by health insurance rules. Here's how to spot con artists and protect yourself.
Ways to Save Money on Obamacare in TexasThree ways Texas residents can reduce the costs of health care coverage under the Affordable Care Act (Obamacare).
Obamacare for Self-Employed Texas ResidentsWhat sole proprietors and independent contractors in Texas should know about health insurance under the Affordable Care Act (Obamacare).
What Domestic Partners Need to Know About Applying for Health Insurance Under ObamacareIf you're a registered domestic partner or have entered into a civil union, how you apply for coverage under the Affordable Care Act (Obamacare) depends on Texas’s law.
Obamacare and SeniorsFor seniors, coverage options under the Affordable Care Act depend on whether or not you're covered by Medicare.
How Obamacare Can Help Unemployed Texas ResidentsLearn what the Affordable Care Act (Obamacare) means for unemployed residents of Texas, including new options for health insurance coverage.
Obamacare and StudentsFour ways students who need health insurance can get covered under the Affordable Care Act (Obamacare).
Understanding Obamacare's Preventive Health Care BenefitsKnow which services -- including a colonoscopy, mammogram, vaccinations, and many more -- you can get for free under the Affordable Care Act (Obamacare).
When Are You Legally Required to Report “Life Changes” to the Texas Health Insurance Exchange?If you get married, change jobs, or move to a new state, you might have to share your big news with Texas’s health insurance exchange.
What if I live in more than one state?When you have homes in two different states, it may be tricky to decide if you need one health plan or two.
What to Do If You're Frustrated or Fed Up With Healthcare.govMany people have turned to social media to vent and seek solutions -- an insurance agent or broker may also be a big help.