Ranked 12 of 15 states · median $807/mo · CMS PY2026
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A 40-year-old speech therapist in Texas pays a median $807/month for a Silver plan before subsidies — 12th of 15 on cost. The cheapest plan in the state is $540 from Blue Cross and Blue Shield of Texas in Cameron. On median Silver premium, Texas ranks 12 of 15 for this occupation.
Patient-facing and standing work means steady, predictable utilization — regular visits, prescriptions, physical therapy. Copay structure and network breadth drive real annual cost more than the headline premium, so these pages rank states on median premium and carrier count together.
Occupational context: Vocal strain; infectious exposure in clinical settings.
This is background for choosing a plan, not for pricing one. Since 2014 every Texas exchange plan has been guaranteed issue and community rated: same age, same ZIP, same tobacco status means the same filed premium whether you are a speech therapist or an accountant. Occupation changes the shopping criteria, nothing else.
Premium is set by rating area, so a speech therapist in one Texas county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Menard | $920 | Ambetter from Superior HealthPlan | $6,000 | 3 |
| Callahan | $953 | Blue Cross and Blue Shield of Texas | $4,000 | 2 |
| Stephens | $953 | Blue Cross and Blue Shield of Texas | $4,000 | 2 |
| Harris | $586 | Community Health Choice | $4,500 | 7 |
| Hays | $608 | Sendero Health Plans, Local Nonprofit | $6,000 | 9 |
| Jefferson | $625 | CHRISTUS | $5,990 | 6 |
The spread across just these six is $367/month — $4,402 a year for the same metal tier. Statewide the range runs $540 to $1,409. Coverage by County publishes all 254 Texas counties individually.
| Texas — network and cost | 2026 |
|---|---|
| Median Silver premium @40 | $807 |
| Cheapest Silver @40 | $540 — Blue Cross and Blue Shield of Texas (Cameron) |
| Most expensive Silver @40 | $1,409 |
| Carriers filing in the state | 15 — Ambetter from Superior HealthPlan, Baylor Scott and White, Blue Cross and Blue Shield of Texas, CHRISTUS |
| Plan types available | EPO, HMO, POS |
| Counties with only one carrier | 7 of 254 |
Texas has 15 carriers filing and 7 of 254 counties served by a single issuer. For a speech therapist with an established provider relationship, that carrier count is the number that decides whether you keep your doctor.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 13,013 plan records across 254 Texas counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Kansas ($765), Florida ($789), Utah ($805). More expensive: North Carolina ($828), Arkansas ($828), Nebraska ($875).
Side-by-side: Texas vs Florida · Texas vs Utah · Texas vs North Carolina · Texas vs Arkansas
Cross-state numbers are useful for understanding whether Texas is treating you well, not for arbitrage. You cannot buy an out-of-state exchange plan. If you are a speech therapist weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
Expense categories that typically apply to this trade: Licensing, materials, malpractice insurance, CE. Premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or your spouse — a question for your CPA, not your agent.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The cheapest Silver plan for a 40-year-old in Texas is $540 per month from Blue Cross and Blue Shield of Texas, with a state median of $807. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
No. Only EPO and HMO and POS plans were filed for 2026.
Texas ranks 12 of 15 states covered here, at a median $807 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
Above the cliff. At this income a single-person household receives no premium tax credit for 2026 and pays the full premium.
This occupation is above the cliff in all 21 states reported.
What this figure is. It is the median annual wage BLS reports for Speech-Language Pathologists (SOC 29-1127) in Texas. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed speech therapist. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2026 the 400% FPL limit applies again, so household income above $62,600 ends premium tax credit eligibility outright.
This page compares states. For Texas specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for Speech Therapists in Texas and a blog covering deductibles, subsidies and special enrollment.
The biggest change here is a carrier walking away. Cigna leaves the ACA individual market on January 1, 2027 — one of the 15 carriers writing in Texas today. Every a speech therapist on a Cigna plan is moving, and doing nothing just means the marketplace chooses the replacement.
Nobody can tell you your 2027 Texas premium yet. Filings nationally cluster around a 15% median increase, with the full spread running −1% to 54% — and until this state signs off, a specific local number is invention.
Enrollment opens November 1, 2026. Treat December 15 as the deadline: it guarantees January 1 cover on every marketplace, Texas included. Conflicting end dates get quoted because a 2025 rule shortened the window and a court vacated it in June 2026, appeal pending — enrol by the 15th and the argument is irrelevant to you.
One thing 2027 will not fix: no PPO is sold anywhere in Texas. All 254 counties offer HMO, EPO or POS only, so care outside the network is effectively emergency-only. If your work as a speech therapist crosses county lines, weigh that above the premium.
You already know you are changing plans — Cigna is leaving. The only real question is whether you pick the replacement or the marketplace picks it for you, and that is a much easier decision made in August than in the second week of December.
Give me a ZIP and I will tell you three things:
Rates for Speech Therapists in Texas are set by county, not by occupation. Start with your ZIP and I will show you the plans actually filed where you live.