Texas Cliff Calculator — 2026 ACA Subsidy

By Severance Calculator Editorial · Updated

Texas Marketplace: HealthCare.gov

Texas uses a federally-facilitated marketplace (FFM) called HealthCare.gov. Texas residents enroll at HealthCare.gov.

Medicaid in Texas: Texas Medicaid (STAR / STAR+PLUS / STAR Kids = MCO delivery)

Texas has not expanded Medicaid under the ACA. Adults above the pre-ACA income limit and below 100% FPL may fall into a coverage gap — they earn too little to qualify for marketplace subsidies (which start at 100% FPL) but do not qualify for Medicaid.

2026 SLCSP Benchmark Premiums (Texas)

Statewide average monthly second-lowest-cost Silver plan (SLCSP) premiums by age. Actual premiums vary by rating area.

Age2130405060
Monthly SLCSP$450$510$575$803$1,220

2026 ACA Cliff Thresholds by Household Size (Texas)

MAGI above these amounts zeros out the federal Premium Tax Credit. FPL region: contiguous48.

Household size12345
400% FPL cliff$62,600$84,600$106,600$128,600$150,600

Key Facts: Texas ACA

Texas occupies a paradoxical position in the ACA landscape: it is the largest state by population without Medicaid expansion, yet simultaneously one of the highest-enrollment marketplace states in the nation. Texas has not expanded Medicaid under the ACA, and as healthinsurance.org confirms: 'Texas has not expanded Medicaid under the ACA, so there is still a coverage gap in the state.' Approximately 570,000 Texas adults fall into the coverage gap — earning too little to qualify for federal marketplace PTCs (which begin at 100% FPL) but ineligible for Medicaid under Texas's restrictive traditional criteria. KFF data shows Texas accounts for the largest share of coverage-gap adults of any non-expansion state.

Despite non-expansion, Texas has consistently recorded among the highest ACA marketplace plan selections in the country — reflecting the large underlying population of uninsured Texans and the availability of federally-subsidized marketplace plans for those above 100% FPL. Texas uses HealthCare.gov (FFM) for marketplace enrollment and has no state-based exchange. There is no state-funded premium subsidy backfill in 2026. Texas Medicaid covers only narrow traditional categories: parents of dependent children at very low income, pregnant women, children, and individuals with disabilities.

Calculate your Texas ACA cliff

Inputs default to Texas; adjust to your household specifics. Cliff = $62,600 (HH=1) / $128,600 (HH=4).

Your situation

Member ages
self

Coverage

Income

You're under the cliff

100%138%200%300%400%

You are at 319% of the federal poverty level.

Annual PTC
$1,920
$160 / month
MAGI headroom before cliff
$12,600
until you hit 400% FPL

PTC dollar values use a state-level SLCSP estimate; verify your exact second-lowest-cost Silver plan on healthcare.gov for your zip.

Primary Sources

  1. healthinsurance.org — Texas Medicaid non-expansion
    “Texas has not expanded Medicaid under the ACA, so there is still a coverage gap in the state.”
  2. KFF — Coverage Gap: Texas share
    “Texas accounts for 42% of individuals in the coverage gap, the highest share of any state”

FAQ — Texas ACA Cliff

What is the 2026 ACA subsidy cliff in Texas?
For a household of 1, MAGI above $62,600 (400% of the 2025 FPL contiguous-48 base) zeros out the federal Premium Tax Credit under IRS Rev. Proc. 2025-25. Household of 4: $128,600. Texas has no state subsidy backfill, so crossing this threshold eliminates all premium assistance.
Did Texas expand Medicaid?
No — Texas has not expanded Medicaid under the ACA and is one of 10 remaining non-expansion states as of 2026. Adults in Texas qualify for Medicaid only under traditional categorical eligibility: parents of dependent children at very low income thresholds, pregnant women, children, and people with disabilities. There is no coverage for non-elderly adults without children who are not disabled.
What is the Medicaid coverage gap in Texas?
The coverage gap in Texas affects adults who earn too little to qualify for federal marketplace PTCs (which begin at 100% FPL / ~$15,650/year for a single adult) but are ineligible for Medicaid. Approximately 570,000 Texas adults fall into this gap — they have no access to subsidized insurance through either Medicaid or the marketplace. KFF estimates Texas accounts for the largest share of coverage-gap adults of any non-expansion state.
How do I enroll in 2026 coverage in Texas?
Texas uses HealthCare.gov (the federally facilitated marketplace) for marketplace enrollment. Open enrollment runs November 1 through January 15. Texas Medicaid accepts applications year-round at yourtexasbenefits.com for those who qualify under traditional eligibility (parents of children at low income, pregnant women, children, disability).
Does Texas have a state subsidy on top of the federal PTC?
No — Texas has no state-funded premium subsidy backfill in 2026. Residents rely solely on the federal Premium Tax Credit. When the ARPA-enhanced subsidies expired at end of 2025, Texas took no state legislative action to backfill the lost assistance.
How is SLCSP calculated for Texas?
The 2026 statewide SLCSP age-band averages for Texas are: Age 21: $450/mo, Age 30: $510/mo, Age 40: $575/mo, Age 50: $803/mo, Age 60: $1,220/mo. Texas is a large and geographically diverse state; Houston metro vs. West Texas rural counties may vary significantly. The federal cliff distance (income vs. 400% FPL) is exact regardless of SLCSP precision.
Can I reduce my MAGI to stay below the 2026 cliff in Texas?
Yes — common strategies include maximizing HSA contributions, deductible IRA or SEP-IRA/Solo 401(k) contributions if self-employed, harvesting capital losses, and deferring Roth conversions. Because Texas has no state subsidy above 400% FPL and no Medicaid expansion, staying below the federal cliff has full dollar impact.

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