A 40-year-old in Taylor County shopping on HealthCare.gov for 2027 coverage will find plans from just one company, Blue Cross and Blue Shield of Texas. For 2026 there were two. Baylor Scott & White Health Plan, which sold marketplace plans in 104 Texas counties for 2026, has none in the federal government’s 2027 plan list, and its departure leaves Taylor, home to Abilene, and 12 other counties with a single insurer.
The health plan, the insurance arm of the Baylor Scott & White hospital system, told state regulators on April 15 that it would stop selling individual marketplace plans after Dec. 31, 2026. It covered about 100,000 marketplace enrollees in Texas and cited changes in how the state awards Medicaid contracts along with the complexity of the individual market.
The benchmark plan in Taylor County now costs $1,035.77 a month before tax credits, up 7.6 percent from $962.55. The benchmark is the second-lowest-cost silver plan, the one federal tax credits are pegged to. The Taylor price is 55 percent above the same benchmark in Harris County, $668.80.
The figures come from a Dispatch comparison of the federal plan landscape files for 2026 and 2027, which list every individual-market medical plan sold on HealthCare.gov, county by county, with premiums by age. The 2027 file was issued Oct. 20 and last updated Oct. 30, according to the federal data catalog. Open enrollment began Nov. 1 and runs through Jan. 15.
Statewide, the number of distinct insurers in the federal file fell from 15 to 13. Besides Baylor Scott & White, Cigna, which sold in 11 counties and is leaving the individual market in all 11 states where it operated, is gone from the 2027 list. So is Moda Health, which sold in three Austin-area counties; Moda filed 2027 rates with the state and still lists 2027 plan materials on its website, so it may be selling only off the exchange. One newcomer, Antidote Health, is selling in 18 counties. Harbor Health expanded from three counties to 13, and WellPoint from 30 to 44. The total number of plans rose from 834 to 907. Blue Cross and Blue Shield of Texas remains the only insurer in all 254 counties.
The number of counties with a single insurer jumped from 7 to 20. All 13 newcomers to that list had Blue Cross and Baylor Scott & White in 2026 and now have only Blue Cross. Most sit in the Big Country around Abilene, including Nolan, Jones, Callahan, Eastland, Haskell and Shackelford, plus Washington County, home to Brenham. In all, 104 counties lost at least one insurer, and 31 gained one.
For a 40-year-old, the benchmark rose in 245 of the 254 counties. The median increase across counties was 8.2 percent. In 112 counties the benchmark rose 10 percent or more, and in 21 it rose 20 percent or more. The biggest jumps came in Knox and Cottle counties, where the benchmark climbed 76 percent, from $563.51 to $991.66, as both went to one insurer. Uvalde, Dimmit and Zavala counties each rose 44 percent, to $1,023.79.
In the big metros, the benchmark rose 13 percent in Harris County, 11.5 percent in Dallas, 13.9 percent in Bexar, 17.8 percent in Travis, 11 percent in Tarrant and 28 percent in El Paso, to $759.52. Fort Bend rose 3.1 percent. Nine counties saw small declines, among them Hidalgo, down 0.7 percent to $644.07, the lowest in the state for 2027, and a group of Gulf Coast counties including Wharton, Matagorda and Waller, each down 3.5 percent to $690.36.
Where insurers are scarce, prices run higher. The median 2027 benchmark is $1,013.71 a month in the one-insurer counties and $734.32 in the 44 counties with five or more insurers. The data does not explain the gap. Insurers price by region, and local hospital costs, provider networks and the health of enrollees all feed into rates.
Insurers had requested increases averaging about 13 percent, according to healthinsurance.org, a consumer site that compiled the filings, and the Dispatch reported in August on the proposed increases. The two measures differ: a requested rate change averages across all of an insurer’s plans, while the benchmark tracks one plan in each county.
These are list prices. Most marketplace buyers qualify for federal tax credits based on income, and the credit covers the gap between the benchmark and a set share of the buyer’s income. A higher local benchmark therefore raises the credit for those who qualify. It leaves the full increase on those who do not qualify and on anyone who picks a plan costing more than the benchmark.
Shoppers who want coverage to start Jan. 1 must pick a plan by Dec. 15. Baylor Scott & White, Cigna and Moda customers will need a new plan for 2027, so the deadline matters most for them.