Who Is Eligible for Obamacare in Texas: Income and Residency

To be eligible for Obamacare in Texas, you need to live in the state, be a U.S. citizen or lawfully present immigrant, and not be incarcerated after a conviction. Anyone who meets those basics can buy a marketplace plan through HealthCare.gov. Whether you also get help paying for it depends on your household income, which generally needs to fall between 100 and 400 percent of the federal poverty level. For a single person in 2026, that is roughly $15,960 to $63,840 per year.¹

You Have to Live in Texas

Federal law defines a “qualified individual” as someone who resides in the state where they apply for marketplace coverage.² You will give a Texas home address when you apply. If you move here from another state, you cannot keep your old plan; you need to start a new application through HealthCare.gov. Moving triggers a special enrollment period, so you don’t have to wait for open enrollment.³

Citizenship and Immigration Status

You need to be a U.S. citizen, U.S. national, or lawfully present immigrant. That last category is broad. It includes green card holders, refugees, asylees, people with valid work or student visas, people with Temporary Protected Status, and victims of trafficking, among others.⁴ People without documented legal status cannot enroll through the marketplace. The application verifies status with a Social Security number or an immigration document number.⁵

Income: Who Qualifies for Financial Help

The main form of help is the premium tax credit, which lowers your monthly payment. Federal law makes it available to households earning between 100 and 400 percent of the federal poverty level who don’t have access to affordable employer coverage or another qualifying government health program.⁶

Here is what those thresholds look like in 2026:

Single person: $15,960 at 100% FPL, $63,840 at 400% FPL
Family of two: $21,640 at 100% FPL, $86,560 at 400% FPL
Family of four: $33,000 at 100% FPL, $132,000 at 400% FPL

For households larger than eight, add $5,680 for each additional person to the poverty guideline.¹ The credit works on a sliding scale: the closer your income is to 100 percent of FPL, the larger your credit, and your expected share of the premium rises as your income rises.⁶

The marketplace calculates income using your household’s modified adjusted gross income (MAGI). That includes wages, tips, self-employment earnings, investment income, Social Security benefits, and other taxable income from everyone in your household who is required to file a tax return. Household size includes you, your spouse if you file jointly, and your tax dependents.

If your income lands above 400 percent of FPL, you can still buy a marketplace plan, you just pay the full premium. Enhanced subsidies had temporarily removed that 400 percent cap for tax years 2021 through 2025, but those credits have expired as of early 2026. Legislation to extend them is pending in Congress; check HealthCare.gov to see whether anything has been enacted, because an extension would meaningfully widen who gets help.

If your income is low enough to qualify (between 100 and 250 percent of FPL) and you pick a Silver-tier plan, you also get cost-sharing reductions that lower your deductibles, copays, and out-of-pocket maximum. These extra savings only come with Silver plans. Pick Bronze, Gold, or Platinum and you keep the premium credit but lose the cost-sharing help.⁷

The Texas Coverage Gap

Texas has not expanded Medicaid under the ACA, and that creates a trap for very low earners. Traditional Texas Medicaid covers few adults, mostly pregnant women, parents with extremely low incomes, and people with disabilities. Most childless adults don’t qualify no matter how little they earn. At the same time, marketplace premium tax credits start at 100 percent of FPL ($15,960 for a single person in 2026).¹

If you earn less than that and don’t qualify for Texas Medicaid, you fall into the coverage gap: too much for Medicaid, too little for subsidies. You can still apply through the marketplace to see what’s available, but you may not get financial help with premiums.

Other Coverage That Disqualifies You From Subsidies

Government Health Programs

If you are enrolled in or eligible for certain government programs, you generally cannot receive premium tax credits. These include Medicare Part A and Medicare Advantage, most forms of Medicaid, the Children’s Health Insurance Program (CHIP), TRICARE, and some veterans’ health coverage.⁸ Limited-benefit coverage like standalone dental or vision does not count against you.⁹

Employer-Sponsored Insurance

If your employer offers coverage that is both affordable and meets a minimum-value standard, you generally cannot get a marketplace subsidy. For 2026, employer coverage counts as affordable when your share of the premium for the lowest-cost self-only plan is no more than 9.96 percent of your household income.¹⁰ The plan meets minimum value if it covers at least 60 percent of average total costs.

If the employer plan fails either test, you can enroll in a marketplace plan and claim premium tax credits based on your income.

Incarceration

If you are currently serving a sentence in jail or prison after a conviction, you cannot enroll in a marketplace plan.¹¹ Being held while awaiting trial doesn’t disqualify you; you can still apply.² Once released after a conviction, you qualify for a special enrollment period and can sign up right away.¹²

When You Can Sign Up

Being eligible is only half the story; you also need to be inside an enrollment window. Open enrollment runs November 1 through January 15.¹³ Enroll by December 15 and coverage starts January 1; enroll between December 16 and January 15 and coverage starts February 1.

Outside that window, you need a qualifying life event to trigger a special enrollment period, and you usually have 60 days from the event to enroll. Qualifying events include:¹²

Losing other coverage (employer plan, aging off a parent’s plan at 26, losing Medicaid or CHIP)
Getting married, having or adopting a child, or losing coverage through divorce or a death
Moving to a new ZIP code or county, moving to the U.S. from abroad, or moving to or from a school, seasonal work, or shelter
Becoming a U.S. citizen, being released from incarceration, gaining tribal membership, or being affected by a natural disaster

Without open enrollment and without a qualifying event, you generally cannot get marketplace coverage until the next November.

What’s Different for 2026

Two changes are worth knowing before you commit to a plan. First, the enhanced subsidies that let higher earners (above 400% FPL) qualify for help have expired, so the 400 percent ceiling is back in force unless Congress acts.

Second, the cap on repaying excess advance credits is gone. In prior years, if you received more premium tax credit during the year than your final income entitled you to, your repayment was limited for households below 400 percent of FPL. For 2025, a single filer below 200 percent of FPL owed no more than $375 back. That cap no longer applies for 2026, so if you underestimate your income, you could owe back the full excess at tax time.¹⁴ Report income and household changes to the marketplace as soon as they happen so your monthly credit tracks your actual income.¹⁵

One more thing that affects future eligibility: if you take advance premium tax credits, you have to file a tax return and reconcile them on Form 8962. Skip that step and you lose eligibility for both premium tax credits and cost-sharing reductions the following year.¹⁶

1
Federal Register. Annual Update of the HHS Poverty Guidelines
2
Office of the Law Revision Counsel. 42 USC 18032 – Consumer Choice
3
HealthCare.gov. How to Report a Move to the Marketplace
4
HealthCare.gov. Coverage for Lawfully Present Immigrants
5
HealthCare.gov. Immigration Status and the Marketplace
6
Office of the Law Revision Counsel. 26 USC 36B – Refundable Credit for Coverage Under a Qualified Health Plan
7
HealthCare.gov. Cost-Sharing Reductions
8
Centers for Medicare and Medicaid Services. Minimum Essential Coverage
9
Internal Revenue Service. Find Out if Your Health Insurance Coverage Is Considered Minimum Essential Coverage
10
Internal Revenue Service. Rev Proc 2025-25
11
HealthCare.gov. Health Coverage for Incarcerated People
12
HealthCare.gov. Special Enrollment Opportunities
13
HealthCare.gov. A Quick Guide to the Health Insurance Marketplace
14
CMS: Agent and Brokers FAQ. Are There Limits to How Much Excess Advance Payments of the Premium Tax Credit Consumers Must Pay Back
15
Internal Revenue Service. The Health Insurance Marketplace
16
Internal Revenue Service. Premium Tax Credit: Claiming the Credit and Reconciling Advance Credit Payments