Texas has the second-largest Affordable Care Act (ACA) individual Marketplace in the country, and few enrollees sign up without help. Four in five Texans who select an ACA plan do so through a licensed insurance broker, a share that has grown substantially since the Marketplace’s early years and now exceeds that of nearly every other state. Texas Marketplace enrollment has grown more than fivefold since the program began, from roughly 734,000 plan selections in the first open enrollment period in 2014 to approximately 4.17 million in 2026.

Enrollment has since declined. After premium subsidies were reduced at the end of 2025, some enrollees did not effectuate coverage and others dropped it, reducing covered lives in Texas to 3.3 million.

This reliance on brokers changes how access to individual coverage should be assessed. Affordability is one question; the other is whether a family can reach someone, in person or by phone, who can help them choose a suitable plan. The Marketplace is now the largest source of individually purchased health coverage in the state.

This report combines several public datasets (CMS enrollment records, the CMS broker registry, and lists of Navigator and Certified Application Counselor (CAC) sites) to address three questions: where enrollment help exists, where it is thin, and what changes could widen the gaps.