Most Texans don't realize they qualify for help with health insurance premiums. The subsidy structure is income-based, household-size-adjusted, and applies automatically when you enroll through the marketplace.
Premium tax credits
These reduce your monthly premium. The amount scales with household income relative to the federal poverty level. As of plan year 2025 (Inflation Reduction Act enhancements), households earning above 400% FPL can still qualify for partial credits.
Cost-sharing reductions (CSRs)
If you qualify for a premium tax credit AND your income is below 250% FPL, you also qualify for cost-sharing reductions on Silver-tier plans — meaning lower deductibles, copays, and out-of-pocket maxes.
Realistic Texas examples
- Single, age 32, $45,000/yr in Houston: ~$280/month for a Silver plan after subsidy.
- Family of 4, $75,000/yr in Dallas: ~$420/month for a Silver plan after subsidy.
- Self-employed, age 55, $90,000/yr in Austin: ~$680/month for a Silver plan after partial subsidy.