Health insurance in Hidalgo County, Texas
5 insurers sell 78 marketplace plans here, and 26.7% 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.
Who sells here, and how much choice that gives
5 insurers compete in Hidalgo County with 78 plans between them, about 16 plans each. The number has not changed since the previous plan year.
Coverage is worse here than across the state
26.7% of Hidalgo County's 785,748 under-65 residents have no health coverage — 209,777 people. That is far higher than Texas as a whole, which sits at 19.1% — 7.6 points above its own state, and puts Hidalgo County in the top 1% of the 1,817 counties on this site (13th).
Some of those 209,777 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
210,638 Hidalgo County residents selected a marketplace plan for 2026: 268 per thousand under-65 residents, 32nd of 1,817. That is 3.4× the 78 per thousand typical here. 28,089 of them — 13% — were new rather than renewing.
Hidalgo County against Texas
Hidalgo County is the 9th largest of the 43 Texas counties we publish. Its uninsured rate runs 7.6 points higher than Texas overall and its 5 insurers sit between the state's 1 and 10. Marketplace use is about 1.7 times the Texas rate.
| Hidalgo County | Texas | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 26.7% | 19.1% | 9.9% |
| Insurers selling | 5 | 1–10 | 4 |
| Plans offered | 78 | — | 57 |
| Selections per 1,000 | 268 | 159 | 78 |
| New rather than renewing | 13% | 18% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Fort Bend County | 816,264 | 13.0% | 7 | 107 |
| El Paso County | 735,209 | 23.7% | 7 | 110 |
| Denton County | 910,036 | 11.7% | 8 | 117 |
| Montgomery County | 640,879 | 17.4% | 8 | 112 |
Denton County has 8 insurers against this county's 5 — a reminder that the county line, not the state line, is what decides your options.
Other Texas counties · Where the subsidy stops · Enrollment dates