Health insurance sign-ups open Nov. 1 with premiums rising again. Where Austin's safety net and the council fit

Open enrollment for Affordable Care Act marketplace plans begins Sunday, Nov. 1, and runs through Jan. 15, 2027. For the second year in a row, many Austinites who buy their own coverage will see double-digit premium increases, the Austin Chronicle reported.

What is changing

According to the Chronicle:

• Insurers have proposed a median increase of 13.1% in Texas for 2027 and about 15% nationally. The 2026 median increase was 20%.
• Nearly 3.3 million Texans were enrolled in marketplace plans as of February 2026. Nationally, about 3 million fewer people had marketplace plans than a year earlier.
• The increases follow the expiration of enhanced federal premium tax credits, along with rising medical and drug costs.
• Households earning 100% to 400% of the federal poverty line may still qualify for tax credits; for one person, that is $15,960 to $63,840 a year. Starting next year, eligibility for those credits is limited to citizens, green card holders and a few other groups.
• People who have not filed taxes in past years can be denied a marketplace plan for 2027, an enrollment specialist at Foundation Communities told the paper.

Where to get help

• HealthCare.gov is the federal marketplace for Texas residents: healthcare.gov.
• Foundation Communities' Prosper Health Coverage program offers free enrollment help, according to the Chronicle, and has helped more than 65,000 Texans since 2014.
• Central Health, the Travis County hospital district, runs the Medical Access Program (MAP) for low-income county residents without other coverage: centralhealth.net.

What our records add

Central Health warned the council in October. At the council's Oct. 7 Public Health Committee meeting, a Central Health presenter said MAP and MAP Basic enrollment had increased about 2% year over year through August, and that federal policy changes continue to affect Affordable Care Act enrollment. Later in the meeting, the discussion turned to people who have dropped out of the marketplace.

The council helps pick Central Health's leaders. The council appoints members of the Central Health Board of Managers, which oversees the district's budget and programs. In January it reappointed Eliza May to the board, 11-0. On Nov. 4, the Public Health Committee will discuss candidates in closed session and may act on new appointments, according to the committee agenda.

Central Health's spending came up in the social services review. At a Sept. 22 work session, Council Member Vanessa Fuentes, who chairs the Public Health Committee, noted that Central Health has made a very significant increased investment as the council weighed its own social services spending.

Other city business with Central Health. The council has approved recent lease agreements with Central Health without dissent, including a 60-month lease extension in January, 11-0.

What's next

• Nov. 1: Marketplace enrollment opens.
• Nov. 4: The Public Health Committee takes up Central Health appointments.
• Jan. 15, 2027: Open enrollment closes, according to the Chronicle.