Texas ACA Premiums Jump Again for 2027, Insurers Exit

Your book is about to get loud

Somewhere in the next few weeks, a chunk of your Texas ACA clients are going to open a renewal notice and see a number that is meaningfully bigger than what they paid this year. Some of them are going to see a letter that says their plan does not exist anymore, because the company that sold it to them is leaving the state's individual market at the end of December. Neither of those things is a rumor. Both are already sitting in preliminary rate filings that carriers submitted to Texas regulators this summer, and they are public.

You already know the shape of what happens next, because you lived through a version of it last year. The phone rings. The client is not calling to say thank you. They want to know why their premium went up, whether they can do anything about it, and whether you knew this was coming. The honest answer to that last question, this year, is yes. The filings have been public since summer. The only question left is whether your agency reaches those clients before the renewal notice does, or after.

This piece is not a general explainer on how ACA pricing works. It is the specific, sourced picture of what is filed for Texas 2027 coverage, what it means for the clients on your book right now, and the two things worth doing before November 1 so the calls you get are ones you already saw coming.

What's actually driving the 2027 increase

KFF's own tracking of preliminary 2027 filings, updated August 3, 2026, covers 276 insurers across all 50 states and DC and lands on a median proposed increase of 15 percent¹. ACA Signups' independent tracker, built directly from state rate filing databases rather than a survey, put the national weighted average at about 15.2 percent in its August 31, 2026 update². Two different organizations, two different methods, landing within two tenths of a point of each other. That is about as close to confirmed as a preliminary number gets.

KFF's analysis names three things driving it. First, the underlying cost of medical care and prescription drugs is up 10 percent for 2027, ahead of the roughly 8 percent average growth insurers had been pricing in for the last several years, with GLP-1 medications, hospitalization costs, and labor shortages named specifically¹. Second, the enhanced premium tax credits that had boosted ACA subsidies expired on schedule at the end of 2025, which KFF says already drove a 58 percent average increase in what subsidized enrollees paid out of pocket in 2026, and pushed healthier enrollees out of the risk pool¹. Third, insurers estimate that sicker risk pool alone added about 4 percentage points to 2026 premiums, and expect another 4 points from the same effect in 2027¹.

None of the three drivers KFF names are unique to Texas, which is worth sitting with for a second, because it means the state's carriers are not filing double digit increases out of caution or local politics. They are pricing the same national cost trend everyone else is. KFF's own writeup names GLP-1 medications, hospitalizations, physician visits, and labor shortages as contributing factors behind the 10 percent medical trend figure, alongside general economic inflation¹. Layer a risk pool that lost its healthiest members when the subsidy cliff hit at the start of 2026, and the filing math stops looking mysterious. It is several ordinary cost pressures arriving in the same plan year, on top of a subsidy structure that already changed once.

How much Texas premiums are rising, carrier by carrier

Texas's own weighted average sits close to, but slightly under, the national figure. ACA Signups calculates a 14.1 percent weighted average increase for the Texas individual market based on preliminary filings from 16 carriers, updated August 28, 2026³. Healthinsurance.org, working from the same public filings independently, arrived at a 13.1 percent average increase before subsidies are applied⁴. The two figures do not match exactly, because one is enrollment weighted and the other is a simple average across carriers, but both land in the same narrow band, and neither is a rounding error away from last year's increase.

The state average hides a much wider spread underneath it. Individual carrier filings range from modest to steep, and the carriers with the biggest books are not always the ones with the smallest increases.

It is worth being precise about why the two published averages, 14.1 percent and 13.1 percent, do not match exactly, because the difference matters when you are explaining a bill to a client. ACA Signups weights its number by enrollment, so a carrier with more members counts for more of the average, which is closer to what an actual renewing book experiences in aggregate³. Healthinsurance.org's 13.1 percent is a simple average across the filed carriers, treating a company with 500,000 members the same as one with a few thousand⁴. Neither method is wrong. They answer slightly different questions, and a client asking "is this normal" deserves the weighted answer, since it reflects what most Texans on the exchange are actually seeing, not what the average filing looks like on paper.

Two carriers are leaving: what a crosswalk means for your clients

The rate increases are the loud part. The exits are the part that actually forces someone to act. Cigna and Baylor Scott & White are both leaving the Texas individual ACA marketplace at the end of 2026 and will not offer 2027 coverage, taking Texas from 16 participating insurers down to 14³⁴. Neither is a boutique carrier with a handful of members. Every client your agency has on either plan needs a new one for January 1, whether they realize it yet or not.

Here is the mechanism, and it is worth knowing precisely, because it decides who ends up in control of the outcome. According to the Center on Budget and Policy Priorities, when a plan is discontinued, HealthCare.gov automatically enrolls the client in a replacement plan that is "as similar as possible to their previous plan, based on a hierarchy established in regulations"⁹. If the exiting carrier has no comparable option in the client's county, which is exactly the situation for anyone whose plan disappears because the issuer left the state's market entirely, the marketplace can cross map that client into a plan from a completely different company, sometimes at a different metal level or network than what they are used to.

The subsidy question nobody has answered yet

Every number in this article assumes the enhanced premium tax credits stay expired, because that is what the people who filed these rates assumed. The credits lapsed on schedule at the end of 2025. The House passed a three year extension on January 8, 2026 by a 230 to 196 vote, with 17 Republicans joining Democrats, but the bill stalled in the Senate, where lawmakers from both parties acknowledged at the time that a similar three year extension effort had already failed there once⁸.

Eight months later, nothing has changed that outcome. KFF's own July and August 2026 rate analyses are explicit that insurers priced 2027 assuming no reprieve, citing "the expiration of enhanced premium tax credits at the end of 2025" as a settled input to the filings, not an open question¹. If Congress does eventually act, which remains possible on paper and has not happened despite eight months of trying, the rates in this article would need to be revisited. Until that changes, the responsible thing to tell a client is what the filings actually say, not what might happen if a stalled bill suddenly moves.

Put it in front of a client plainly and it sounds like this: the extra help that lowered their premium the last few years is gone, it has been gone since January 1, 2026, and nobody in Washington has restored it despite one House vote and months of Senate negotiation. That is a harder message than "your rate went up a little," but it is the accurate one, and clients tend to trust an agent who says it plainly over one who implies a fix might arrive before their next payment is due. Nothing about the SAA build discussed later in this piece changes that message. It only changes how fast and how personally that message reaches the client.

A compressed calendar, a bigger book

The calendar Texas agents are working with almost got shorter. CMS had proposed cutting the Open Enrollment window to no more than nine weeks starting this year, but a federal court vacated that plan, and CMS confirmed in an August 3, 2026 update that the full window survives for 2027⁶. Open Enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027⁶. Count the days and that is 76, not the 63 a nine week window would have allowed, but still a fixed, short runway for a state with a very large book to move through it.

How large is not a guess. Texas posted 4,172,233 ACA marketplace plan selections during the 2026 Open Enrollment Period, according to CMS's own national snapshot report, published January 28, 2026, more than any other state on the federal platform⁵. Every one of those clients is a renewal this cycle. A meaningful share of them are on a plan from a carrier that is leaving, or a plan whose price just moved by double digits. None of that volume gets more time to process than the 76 days everyone else gets.

What it costs an agency that waits for the phone to ring

Put a real number on the labor side of this. BLS puts the median hourly wage for an insurance sales agent at $29.94 as of May 2025⁷. Every renewal call that starts with "why did my bill go up" instead of "I already know, let's talk about options" is a producer or a CSR spending that hourly value reacting to a surprise, instead of running a conversation they controlled the timing of. Multiply that by however many clients on your book sit with Cigna or Baylor Scott & White, or on a plan whose renewal jumped double digits, and the reactive version of this season is not free. It is just a cost nobody put a line item on, because there was never data specific enough to price it against before the filings became public.

There is a retention cost sitting next to the labor cost. A client who gets auto-mapped into an unfamiliar plan and then finds out from a pharmacy counter that their drug is no longer covered does not usually call you to ask what happened. They call whoever answers the phone fastest, and increasingly that is a competing agency, an AI receptionist at a bigger downline, or a direct carrier line. The client was never lost to a better rate. They were lost to whoever reached them first with an actual answer.

How to prepare your own process

None of this requires buying anything. A disciplined agency, even a small one, can get most of the way there with a weekend of list work and a script rewrite before November 1.

Pull every client currently on Cigna or Baylor Scott & White first. This is a finite, identifiable list inside your own CRM or your carrier commission statements. These are the clients who lose their plan outright, not just see a higher bill, and they are the ones a marketplace auto-map decision affects most directly. They should hear from you before the marketplace's own notice arrives, not after.

Segment the rest of your book by rate increase, if you can get carrier level detail. A client on a plan with a 14 percent increase and a client on one with a 31 percent increase are not the same conversation. The second group needs a re-shop conversation this cycle, not a routine "your plan renewed" notice. Knowing which group someone falls into before you call them is the difference between sounding prepared and sounding like you are guessing.

Rewrite the opening line of your renewal call or text. "Your plan renewed" is the wrong opener for a season where a meaningful share of renewals come with a real increase or a forced plan change. "I saw your renewal before it hit your mailbox, here is what changed and here are your options" is a completely different first impression, and it costs nothing except knowing the number before the client does.

Decide your after hours coverage before AEP season stacks on top of this. Texas agents writing Medicare Advantage and Part D are about to hit their own compliance deadline crunch at the same time this ACA renewal wave lands. If your only after hours option is a voicemail box, a client with a real question about a real increase is not going to wait until Monday to ask a competitor instead.

Build a short, honest talk track for the exits specifically. A client whose carrier is leaving did not do anything wrong, and neither did you. The clearest thing you can say is close to the truth: their old company stopped selling ACA plans in Texas, here is what replaces it, and here is why the option you are suggesting fits their situation better than whatever the marketplace would assign automatically.

Check your own site's calculator before a client does. If your website carries a static ACA cost estimate or a quoting widget built around last year's numbers, a client who plugs in their own information before calling you sees a figure that is already wrong by double digits. That does not just create a confusing call. It quietly undercuts the credibility of everything else on the page, at the exact moment a shopper is deciding whether to trust your site or move on to the next search result.

How Ambrose closes the gap

The rate filings are a market event. What they expose is an operations question: can your agency reach the right clients, with the right message, before the marketplace's own default plan assignment does it for them, and can you answer the calls that come in after, at whatever hour they land. That is the specific gap Ambrose, the AI platform we build custom for agencies, is designed to close.

Ambrose's own documentation describes it as "an agentic AI operating system built for insurance agencies," structured as a back office of named AI department heads built for ACA, Medicare, ICHRA, and group health workflows specifically, connected to the systems an agency already runs, including GoHighLevel, HealthSherpa, Twilio, and voice providers¹⁰. For a renewal season shaped like this one, that means a segmented outreach campaign to exactly the clients on an exiting carrier, sent with the right context before their renewal notice lands, plus a conversational AI or voice AI that can take the "why did my premium go up" call at 9pm on a Tuesday with the same context a producer would have, not a generic script.

The context is the part that actually matters, more than the outreach itself. A mail merge can send a hundred letters that all say the same thing. What makes a message land is knowing which plan a specific client is on, what changed for that plan specifically, and whether they have already called in confused this year. Building that on your own accounts, your own domain, and your own CRM, priced to the actual work rather than a flat retainer, is what a custom build through our AI Expert program does. We scope it on a call and price it to what your agency actually needs, and you own what gets built¹¹.

Think about what the two halves of this problem actually require. The outreach half is a segmentation and messaging job: know who is on Cigna or Baylor Scott & White, know what their replacement looks like, and reach them before the auto-map notice does. The inbound half is a coverage job: whoever calls after that outreach, or after their own renewal notice arrives unprompted, needs an answer that sounds like it came from someone who already knows their file, not a hold queue. A generic answering service can pick up the phone. It cannot tell a caller which plan replaced their old one or why the new premium looks the way it does. That is the difference between a system that reduces call volume and one that just reroutes it.

What you get

Concretely, an agency that closes this gap gets a renewal season where the clients on an exiting carrier hear from you first, not from a marketplace notice that assigns them a plan they never chose. It gets a phone or a text that answers a rate increase question at 9pm with the same context a producer would have, instead of a voicemail box that adds a day of uncertainty to a client who is already annoyed. It gets fewer clients who quietly drift to whichever agency or carrier line answered first. None of that is a promise about retention numbers or income, and we are not going to pretend it is. It is an operations decision about whether your agency controls the timing of this season's hardest conversations, or reacts to them.

When this doesn't change much for you

If your book runs mostly Medicare Advantage, Part D, or life insurance, this specific article does not touch your calendar. The rate filings, the carrier exits, and the subsidy fight described here are ACA individual marketplace facts, governed by different rules than Medicare or life business. If you write ACA but your book has almost nobody on Cigna or Baylor Scott & White and your clients' renewals are landing under 10 percent, the urgency here is lower for you specifically, though the subsidy uncertainty and the fixed 76 day window still apply to whatever renewal conversations you do have. And if you already run a live team that reaches every renewing client personally before their notice arrives, you are already doing the hard part of what this article recommends. The gap this piece is about is specific: carrier exits plus double digit increases plus a fixed calendar, landing on an agency with no proactive process to get ahead of any of it.

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