The Affordable Care Act (Obamacare) expanded Medicaid eligibility to include more people who couldn’t otherwise obtain health insurance. As written, the ACA would extend Medicaid to all adults with incomes at or below 138% of the federal poverty level. (For a single person in Texas in 2021, that’s $18,754. For a family of four, it’s $38,295.)
However, the U.S. Supreme Court later ruled that it was up to individual states to decide whether to expand Medicaid. As of October 2021, 12 states have not expanded their programs.
Texas Has Not Expanded Medicaid
Because Texas has not yet expanded Medicaid eligibility, you may have fewer options for health coverage than people in states where Medicaid is more inclusive.
The Medicaid Coverage Gap
The Affordable Care Act assumed that Medicaid would be expanded to cover all Americans with incomes at or below 138% of the federal poverty level. And it created health plan subsidies for people with incomes between 100% - 400% of the poverty level.
That means Texas residents with incomes below the poverty level may fall into a coverage gap where they can get neither Medicaid nor ACA subsidies.
Find Out What Health Plans and Programs You Qualify For
To learn whether you're eligible for Medicaid in Texas, contact the Texas Medicaid office.
You can also find out whether you qualify when you apply for health insurance at Healthcare.gov. If you don’t meet Texas’s Medicaid requirements, Healthcare.gov will show you the private health insurance plans available to you. You may still be eligible for significant cost-saving subsidies based on your income and family size.
For more information, see Ways to Save Money on Obamacare in Texas.