Texas leads the country in self-employment, and most self-employed Texans buy health insurance one of three ways: marketplace, private, or short-term. Each has trade-offs that depend more on how you actually use healthcare than on the premium number.
Marketplace (ACA-compliant)
The default. Pre-existing conditions covered, essential health benefits required, premium tax credits available based on household income. For most self-employed Texans, this is the right answer — especially if you have ongoing prescriptions or specialists.
Private (off-marketplace)
Same carriers, same networks, but purchased directly without going through healthcare.gov. Useful when you don't qualify for subsidies and want plan flexibility. Same coverage rules apply (pre-existing conditions covered, etc.).
Short-term
Cheap and limited. Doesn't cover pre-existing conditions, often excludes maternity and mental health, can deny coverage. Right tool only for healthy people bridging short gaps.
The deduction nobody mentions
Self-employed Texans can deduct 100% of health insurance premiums on Schedule 1 of their federal return — bringing the effective cost down materially. Your CPA will set this up; we coordinate if needed.