TEXAS (November 20, 2025) – Texas already ranks as the highest uninsured rate in the nation, with 16.6% of residents—nearly 5 million people—uninsured, including over 852,000 children. As Washington remains at a standstill over whether to continue or end the federal subsidies that make Marketplace health plans affordable, Texas families face rising healthcare costs and shrinking options.   

Without continued premium subsidies, the uninsured rate could climb to 20%, with an estimated 1.4 million Texans—including 235,000 children—losing coverage.  Losing coverage doesn’t mean just a greater uninsurance rate, it also means a greater cost to healthcare coverage and services for all Texans.  Family premiums could double, adding up to $2,000 more per year for households already struggling with the cost of living. 

“The Marketplace has been a lifeline for Texas children and families who have no other affordable option,” said Dr. Bob Sanborn, President and CEO of CHILDREN AT RISK. “When families lose affordable coverage, we all pay more.”  

On Thursday, November 20th, CHILDREN AT RISK hosted a virtual press conference to convene local experts and health providers to debunk the myths and expose the realities that this shift in the healthcare landscape will have on all Texans. 

When families lose health insurance, the consequences ripple across the state and touch every community, regardless of income level.  Overall costs for care and services will increase, while the health of our communities will deteriorate with delayed care, missed medications, and lost preventive services. 

Open Enrollment for ACA Marketplace coverage is underway (November 1, 2025 – January 15, 2026) and Texans who have opted into to re-enrollment policies may be unaware they’re being automatically reenrolled for the same plan but with exponentially higher costs. In Texas, more than 1.4 million enrollees — or 36% — automatically re-enrolled in ACA plans last year, according to data from the Centers for Medicare and Medicaid Services.   

This year, experts warn, is not the year to “set it and forget it.” Recommendations to protect the economic interests of families include: 

• Shop, don’t autopilot. Check premiums, deductibles, prescriptions, and provider networks before renewing. 

• Get free help. Local navigators and community health centers can help at no cost. 

• Enroll early. Avoid last-minute technical or paperwork issues.