Texas February Marketplace Effectuated Enrollment Was 3.28M in 2026 — 4% Below 2025 and Distinct From Plan Selections
CMS's February effectuated-enrollment data show about 3.28 million Texans with active Marketplace coverage in 2026, down from about 3.42 million in the comparable 2025 file. CMS separately reported about 4.17 million Texas plan selections during the 2026 open-enrollment period.
The roughly 888,000 difference is a difference between measures and observation points; it does not prove that every person in the gap failed to pay, became uninsured, or sought FQHC care. Coverage and revenue-cycle teams should use current official eligibility and payer information for each encounter, record the aggregate signal separately from patient status, and keep applications, notices, income, immigration status, and clinical or billing data out of FQHC Talent.
Key takeaways
- February effectuated enrollment and open-enrollment plan selections are different measures; label both the measure and period when briefing leaders.
- Do not infer an individual's coverage, eligibility, payment status, or care use from the statewide aggregate gap.
Linked evidence
Centers for Medicare & Medicaid ServicesSource packet
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FQHC Talent. (2026, July 9). Texas February Marketplace Effectuated Enrollment Was 3.28M in 2026 — 4% Below 2025 and Distinct From Plan Selections. Linked evidence: Centers for Medicare & Medicaid Services. Retrieved September 20, 2026, from https://www.fqhctalent.com/intel/tx-aca-marketplace-enrollment-decline-4pct-2026
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