Health insurance premiums on the Affordable Care Act (ACA) marketplace are rising again, and Harlingen-area residents who buy their own coverage have until Jan. 15 to shop for 2027 plans.
Open enrollment on HealthCare.gov began Sunday, Nov. 1. Residents who enroll by Dec. 15 can have coverage starting Jan. 1, while those who enroll from Dec. 16 through Jan. 15 can have coverage starting Feb. 1.
Across the country, marketplace insurers proposed a median premium increase of about 15% for 2027, according to an analysis by KFF, a health policy research organization. That is a national measure of insurers' requested increases, not a forecast of what any particular Harlingen household will pay.
The proposed hike follows a year in which the nationwide median rate change was initially proposed at 18% but finalized at 20%. It marks a second consecutive year of double-digit increases, following several years of relatively modest premium growth.
A newer KFF analysis of the 2027 enrollment period found that finalized benchmark silver premiums rose an average of 13% nationally. Those benchmark prices affect the calculation of federal premium tax credits, while each household's actual costs depend on its plan, income, age and eligibility for financial assistance.
The increases present challenges in Texas, where many residents already struggle to obtain affordable coverage.
Texas Medicaid coverage gap
Texas remains one of 10 states that have not expanded Medicaid eligibility under the ACA.
That leaves many adults who earn too much to qualify for the state's limited Medicaid program but too little to receive regular ACA marketplace premium subsidies without an applicable exception.
According to KFF's July 2026 analysis, approximately 1.2 million uninsured adults fall into this coverage gap across the 10 states that have not expanded Medicaid, including Texas.
For Harlingen-area residents, the distinction matters because marketplace enrollment does not guarantee eligibility for subsidies or an affordable premium.
Enrollment already falling
ACA marketplace enrollment nationally declined in 2026 after enhanced federal premium tax credits expired at the end of 2025.
According to KFF's enrollment analysis, the number of people with active marketplace coverage fell from 21.8 million in 2025 to 19.2 million in February 2026, a decline of approximately 12%.
The drop coincided with higher costs for many consumers who previously received additional financial assistance.
Texas residents considering 2027 coverage should compare total annual costs rather than monthly premiums alone. Deductibles, copayments, prescription coverage and participating doctors can vary substantially between plans.
Blue Cross and Blue Shield of Texas says it will continue offering individual and family insurance options for 2027, including products available statewide. Those marketplace plans are separate from the company's Medicare products.
Medicare Advantage changes
Older residents face a separate insurance disruption.
Blue Cross and Blue Shield of Texas announced that it will discontinue its Blue Cross Medicare Advantage, MedicareRx prescription drug and Medicare Advantage Dual Care Plus plans for the 2027 plan year.
The decision does not mean the company is withdrawing from Texas's ACA marketplace.
Members affected by the Medicare changes should review their coverage notices and compare available alternatives before the Medicare enrollment deadline.
Medicare's annual open enrollment period runs from Oct. 15 through Dec. 7. Changes made during that period take effect Jan. 1, 2027.
Members whose plans are ending should check their available options, including Original Medicare, Medicare Advantage plans offered by other insurers and separate prescription drug coverage where needed.
Medicare plans are not purchased through HealthCare.gov. Beneficiaries can compare their options through Medicare.gov or by calling 1-800-MEDICARE.
New restrictions on immigrant eligibility
Changes to federal law will also affect financial assistance for some lawfully present immigrants purchasing ACA coverage.
Beginning Jan. 1, 2027, eligibility for marketplace premium tax credits and cost-sharing reductions will generally be limited to qualifying lawful permanent residents, Cuban or Haitian entrants and migrants covered by Compacts of Free Association.
According to HealthCare.gov's official immigration guidance, some people with other lawful immigration statuses may still qualify to purchase marketplace insurance but will no longer qualify for federal financial assistance.
The restrictions could leave affected residents with much higher premiums when their coverage renews.
People who may be affected should review their 2027 eligibility determination and renewal notice carefully rather than assume that last year's subsidy will continue.
Key enrollment dates
- Nov. 1, 2026: ACA marketplace open enrollment began through HealthCare.gov, also available in Spanish at CuidadoDeSalud.gov.
- Dec. 7, 2026: Medicare annual open enrollment closes.
- Dec. 15, 2026: Deadline to select an ACA plan for coverage beginning Jan. 1, 2027.
- Jan. 15, 2027: ACA marketplace open enrollment closes. Plans selected after Dec. 15 generally begin coverage Feb. 1, subject to payment of the first premium.
Harlingen-area residents can review marketplace coverage and available financial assistance directly at HealthCare.gov. Comparing plans during open enrollment can help identify changes in premiums, subsidies, provider networks and prescription benefits before 2027 coverage begins.
