Health insurance in El Paso County, Texas
7 insurers sell 110 marketplace plans here, and 23.7% of under-65 residents have no coverage at all.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release.
7 insurers competing here
7 insurers sell in El Paso County — 110 plans in total, around 16 each. Few people compare 110 plans properly without help. The number has not changed since the previous plan year.
Coverage is worse here than across the state
23.7% of El Paso County's 735,209 under-65 residents have no health coverage — 174,242 people. That is far higher than Texas as a whole, which sits at 19.1% — 4.6 points above its own state, and puts El Paso County in the top 5% of the 1,817 counties on this site (48th).
Some of those 174,242 are in the Texas coverage gap: under $15,960 a year, too little for a subsidy and no expanded Medicaid to fall back on.
The marketplace is used heavily here
135,308 El Paso County residents selected a marketplace plan for 2026: 184 per thousand under-65 residents, 178th of 1,817. That is 2.4× the 78 per thousand typical here. 27,252 — 20% — were new rather than renewing, an unusually high share.
El Paso County against Texas
El Paso County is the 10th largest of the 43 Texas counties we publish. Its uninsured rate runs 4.6 points higher than Texas overall and its 7 insurers sit between the state's 1 and 10. Marketplace use is close to the Texas rate.
| El Paso County | Texas | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 23.7% | 19.1% | 9.9% |
| Insurers selling | 7 | 1–10 | 4 |
| Plans offered | 110 | — | 57 |
| Selections per 1,000 | 184 | 159 | 78 |
| New rather than renewing | 20% | 18% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Hidalgo County | 785,748 | 26.7% | 5 | 78 |
| Fort Bend County | 816,264 | 13.0% | 7 | 107 |
| Montgomery County | 640,879 | 17.4% | 8 | 112 |
| Williamson County | 631,278 | 10.8% | 10 | 110 |
Williamson County has 10 insurers against this county's 7 — a reminder that the county line, not the state line, is what decides your options.
Other Texas counties · Where the subsidy stops · Enrollment dates